To establish the kinetics of BNP levels measured in the PO period of CS, and to correlate the BNP levels with the use of vasoactive amines (VA) in the first PO hour (PO1H).
Prospective study with a cohort of 77 patients (pts) undergoing CS, between August/2003 and January/2005. Mean age 66.9±9.89 years, 22 (28.5%) females, mean Euroscore 4.26. The BNP level was measured in the preoperative period (BNPPre), and in the first (BNP1) and sixth (BNP6) PO hours. Patients receiving VA [(dobutamine (DBT) and/or noradrenaline (NAD)] at any dosage in the first PO hour were assessed and the use of VA was correlated with the BNP1 and BNP6 levels. Statistical analysis: Wilcoxon Matched Pairs Test and Mann-Whitney test.
In the total of sample the mean BNP levels found were as follows: BNPPre = 159.4 pg/mL ± 217.9 (MED = 79.4); BNP1 = 150.2 ± 203.3 (MED = 77.1); and BNP6 = 243.0 ± 237.0 (MED = 168.5), between BNPPre and BNP6, the difference was statistically significant (p = 0.0004). About the use of amines in our sample, 22 pts received VA in the PO1H as follows: 7 pts, NAD + DBT; 12 pts, NAD; and 3 pts, DBT. A significant correlation was observed between the use of DBT and the BNPPre (p = 0.004), BNP1 (0.024), and BNP6 (0.05) levels. The use of NAD did not correlate with the BNP levels. The DBT group had greater mean BNPPre, BNP1, and BNP6 levels than those in the NAD group (790x159, 1004x243, and 609x203pg/dL, respectively).
Was observed the difference between BNPPre and BNP6, this result cans establish a curve of the BNP kinetics in the PO of CS. In the patients using DBT had greater BNP levels than those receiving only NAD, this may correlate with a worse degree of ventricular dysfunction among those pts.
This study showed the curve of the BNP kinetics in the PO period of CS.
Alexandre Felipe, None.