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Abstract: Poster Presentations |

BNP is Not a Predictor of Successful Extubation FREE TO VIEW

David Hersh, MD*; Ken B. Mandell, MD; Athena M. Remolina, DO; Neil Coplan, MD; Elijovich Fernando, MD
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Lenox Hill Hospital, New York City, NY


Chest


Chest. 2004;126(4_MeetingAbstracts):899S. doi:10.1378/chest.126.4_MeetingAbstracts.899S
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Abstract

PURPOSE:  Likelihood of successful extubation in critically ill patients is estimated by respiratory parameters, the predicitive power of which is only modest. Although the sensitivity of a rapid shallow breathing index (RR/TV) is 100%, its specificity is only 63%. We hypothesized that brain natriuretic peptide (BNP), a marker of pressure or volume overload of the heart, could improve this prediction in the cardiac population.

METHODS:  Baseline BNP (Triage BNP, Biosite) was measured in 23 consecutive CCU patients who had reached the point of attempted extubation according to usual clinical criteria.

RESULTS:  Extubation failed in two patients (F). The 21 patients with successful extubation (S) had age 69 ± 4 years, mean arterial pressure 74 ± 3 mmHg, hemoglobin 10.4 ± 0.3 g/l, creatinine 1.3 ± .14 mg/dl, period of intubation 5.5 ± 1 days, ejection fraction 32 ± 3% and RR/TV 35 ± 6.1 breaths*min-1. Baseline BNP was 1212 ± 254 pg/ml and its increase in response to a 60 minute spontaneous breathing trial (SBT) was 308±184 pg/ml. In the failure group (n=2) none of the individual parameters were outside the 95% confidence intervals.

CONCLUSION:  In summary, the preliminary data of this ongoing trial suggest that BNP is not predictive of which patients will fail extubation.

CLINICAL IMPLICATIONS:  Our data suggests that BNP measurement is not useful in determining a patient’s likelihood for successful extubation.

DISCLOSURE:  D. Hersh, None.

Wednesday, October 27, 2004

12:30 PM - 2:00 PM


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