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N-terminal pro-brain natriuretic peptide as a marker of right ventricular dysfunction after open-lung approach in patients with acute lung injury/acute respiratory distress syndrome

Authors
 Young Sam Kim ; Byung Hoon Park ; Moo Suk Park ; Ju Eun Lim ; Eun Young Kim ; Ji Young Son ; Kyung Jong Lee ; Ji Ye Jung ; Young Ae Kang ; Se Kyu Kim ; Joon Chang 
Citation
 Journal of Critical Care, Vol.26(3) : 241~248, 2011 
Journal Title
 Journal of Critical Care 
ISSN
 0883-9441 
Issue Date
2011
Abstract
PURPOSE: The purpose of the study was to evaluate the utility of N-terminal pro-brain natriuretic peptide (NT-proBNP) as a marker of right ventricular (RV) dysfunction after open-lung approach (OLA) in patients with acute lung injury (ALI)/acute respiratory distress syndrome (ARDS). MATERIALS AND METHODS: Twenty-seven patients with ALI/ARDS underwent OLA (2-minute steps of fixed pressure-controlled ventilation with progressive positive end-expiratory pressure levels up to 30 cm H(2)O, followed by stepwise decrement of positive end-expiratory pressure level by 2 cm H(2)O). Patients who showed a PaO(2)/FiO(2) increase of more than 50% from baseline were defined as responders. Plasma NT-proBNP levels were taken immediately before OLA and 2 and 6 hours later. A minimum 30% increase in NT-proBNP level from baseline was considered significant. RESULTS: Right-over-left ventricular stroke work ratio and its percentage change did not differ between responders and nonresponders, whereas these values were higher in patients showing NT-proBNP increase (P < .05). The NT-proBNP percentage change correlated with right-over-left ventricular stroke work ratio percentage change (r = 0.83), pulmonary vascular resistance (r = 0.81), and RV ejection fraction (r = -0.79) and correlated with plateau pressure in nonresponders only (r = 0.82). CONCLUSIONS: In patients with ALI/ARDS, intraindividual NT-proBNP changes correlated with RV afterload following OLA, thereby serving as a potential marker for RV dysfunction after OLA.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/94128
DOI
10.1016/j.jcrc.2010.10.004
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Internal Medicine
Yonsei Authors
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Link
 http://www.sciencedirect.com/science/article/pii/S0883944110002868
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