High levels of B-type natriuretic peptide predict weaning failure from mechanical ventilation in adult patients after cardiac surgery

Imagem de Miniatura
Arquivos
art_LARA_High_levels_of_B_type_natriuretic_peptide_predict_2013.PDF (802.53 KB)
Citações na Scopus
22
Tipo de produção
article
Data de publicação
2013
DOI
SciELO
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
HOSPITAL CLINICAS, UNIV SAO PAULO
Autores
ALMEIDA, Elisangela
Citação
CLINICS, v.68, n.1, p.33-38, 2013
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
OBJECTIVE: The failure to wean from mechanical ventilation is related to worse outcomes after cardiac surgery. The aim of this study was to evaluate whether the serum level of B-type natriuretic peptide is a predictor of weaning failure from mechanical ventilation after cardiac surgery. METHODS: We conducted a prospective, observational cohort study of 101 patients who underwent on-pump coronary artery bypass grafting. B-type natriuretic peptide was measured postoperatively after intensive care unit admission and at the end of a 60-min spontaneous breathing test. The demographic data, hemodynamic and respiratory parameters, fluid balance, need for vasopressor or inotropic support, and length of the intensive care unit and hospital stays were recorded. Weaning failure was considered as either the inability to sustain spontaneous breathing after 60 min or the need for reintubation within 48 h. RESULTS: Of the 101 patients studied, 12 patients failed the weaning trial. There were no differences between the groups in the baseline or intraoperative characteristics, including left ventricular function, EuroSCORE and lengths of the cardiac procedure and cardiopulmonary bypass. The B-type natriuretic peptide levels were significantly higher at intensive care unit admission and at the end of the breathing test in the patients with weaning failure compared with the patients who were successfully weaned. In a multivariate model, a high B-type natriuretic peptide level at the end of a spontaneous breathing trial was the only independent predictor of weaning failure from mechanical ventilation. CONCLUSIONS: A high B-type natriuretic peptide level is a predictive factor for the failure to wean from mechanical ventilation after cardiac surgery. These findings suggest that optimizing ventricular function should be a goal during the perioperative period.
Palavras-chave
B-Type Natriuretic Peptide, Cardiac Surgery, Mechanical Ventilation, Weaning Failure
URI
https://observatorio.fm.usp.br/handle/OPI/1863
Referências
  1. Berendes E, 2004, ANESTH ANALG, V98, P11, DOI 10.1213/01.ANE.0000093249-35075.F1
  2. Bernard F, 2001, ANESTH ANALG, V92, P291
  3. Bouachour G, 1996, EUR RESPIR J, V9, P1868, DOI 10.1183/09031936.96.09091868
  4. Cuthbertson BH, 2009, BRIT J ANAESTH, V103, P647, DOI 10.1093/bja/aep234
  5. Cuthbertson BH, 2007, AM J CARDIOL, V100, P1310, DOI 10.1016/j.amjcard.2007.05.058
  6. Demoule A, 2004, BRIT J ANAESTH, V93, P295, DOI 10.1093/bja/aeh185
  7. Dickstein K, 2008, EUR HEART J, V29, P2388, DOI 10.1093/eurheartj/ehn309
  8. Eliasdottir SB, 2008, ACTA ANAESTH SCAND, V52, P182, DOI 10.1111/j.1399-6576.2007.01451.x
  9. Fellahi JL, 2011, J CARDIOTHOR VASC AN, V25, P256, DOI 10.1053/j.jvca.2010.05.009
  10. Fleisher LA, 2007, CIRCULATION, V116, P1971, DOI 10.1161/CIRCULATIONAHA.107.185700
  11. Fox AA, 2008, J THORAC CARDIOV SUR, V136, P452, DOI 10.1016/j.jtcvs.2007.12.036
  12. Fox AA, 2010, ANESTHESIOLOGY, V112, P842, DOI 10.1097/ALN.0b013e3181d23168
  13. Hutfless R, 2004, J AM COLL CARDIOL, V43, P1873, DOI 10.1016/j.jacc.2003.12.048
  14. Jankowski Marek, 2008, Recent Pat Cardiovasc Drug Discov, V3, P77, DOI 10.2174/157489008784705395
  15. Jeong DS, 2008, J INT MED RES, V36, P31
  16. Jessup M, 2009, CIRCULATION, V119, P1977, DOI 10.1161/CIRCULATIONAHA.109.192064
  17. Ji QA, 2010, HEART LUNG, V39, P275, DOI 10.1016/j.hrtlng.2009.09.002
  18. Maisel A, 2008, EUR J HEART FAIL, V10, P824, DOI 10.1016/j.ejheart.2008.07.014
  19. Maldonado A, 2000, AM J RESP CRIT CARE, V161, P171
  20. Mebazaa A, 2010, CRIT CARE, V14, DOI 10.1186/cc8153
  21. MOHSENIFAR Z, 1993, ANN INTERN MED, V119, P794
  22. Nashef SAM, 1999, EUR J CARDIO-THORAC, V16, P9, DOI 10.1016/S1010-7940(99)00134-7
  23. Natarajan Kanagarajan, 2006, Ann Card Anaesth, V9, P31
  24. Nozawa E, 2005, INT HEART J, V46, P819, DOI 10.1536/ihj.46.819
  25. Nozohoor S, 2011, J CARDIOTHOR VASC AN, V25, P469, DOI 10.1053/j.jvca.2010.07.002
  26. PAULUS S, 1994, CRIT CARE MED, V22, P74
  27. Rao V, 1996, J THORAC CARDIOV SUR, V112, P38, DOI 10.1016/S0022-5223(96)70176-9
  28. ROSSI A, 1985, AM REV RESPIR DIS, V131, P672
  29. ROYSTER RL, 1991, ANESTH ANALG, V72, P729
  30. Schachner T, 2010, CLINICS, V65, P1239, DOI 10.1590/S1807-59322010001200004
  31. Shirzad Mahmood, 2010, Monaldi Arch Chest Dis, V74, P22
  32. Trouillet JL, 2009, J THORAC CARDIOV SUR, V138, P948, DOI 10.1016/j.jtcvs.2009.05.034
  33. Wong DT, 1999, ANESTHESIOLOGY, V91, P936, DOI 10.1097/00000542-199910000-00012
  34. YANG KL, 1991, NEW ENGL J MED, V324, P1445, DOI 10.1056/NEJM199105233242101
  35. Zapata L, 2011, INTENS CARE MED, V37, P477, DOI 10.1007/s00134-010-2101-4

Coleções
Artigos e Materiais de Revistas Científicas - FM/MCP
Artigos e Materiais de Revistas Científicas - FM/MCG
Artigos e Materiais de Revistas Científicas - HC/ICESP
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - HC/InCor
Artigos e Materiais de Revistas Científicas - LIM/08
Carregar mais