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

Byung Hoon Park, Young Sam Kim, Joon Chang, Se Kyu Kim, youngae kang, Ji Ye Jung, Kyung Jong Lee, Ji Young Son, Eun Young Kim, Ju Eun Lim, Moo Suk Park

Research output: Contribution to journalArticle

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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 H2O, followed by stepwise decrement of positive end-expiratory pressure level by 2 cm H2O). Patients who showed a PaO2/FiO2 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.

Original languageEnglish
Pages (from-to)241-248
Number of pages8
JournalJournal of Critical Care
Volume26
Issue number3
DOIs
Publication statusPublished - 2011 Jun 1

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Right Ventricular Dysfunction
Acute Lung Injury
Brain Natriuretic Peptide
Adult Respiratory Distress Syndrome
Lung
Positive-Pressure Respiration
Stroke
Pressure
Vascular Resistance
Stroke Volume
Ventilation

All Science Journal Classification (ASJC) codes

  • Critical Care and Intensive Care Medicine

Cite this

Park, Byung Hoon ; Kim, Young Sam ; Chang, Joon ; Kim, Se Kyu ; kang, youngae ; Jung, Ji Ye ; Lee, Kyung Jong ; Son, Ji Young ; Kim, Eun Young ; Lim, Ju Eun ; Park, Moo Suk. / 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. In: Journal of Critical Care. 2011 ; Vol. 26, No. 3. pp. 241-248.
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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 H2O, followed by stepwise decrement of positive end-expiratory pressure level by 2 cm H2O). Patients who showed a PaO2/FiO2 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.",
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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. / Park, Byung Hoon; Kim, Young Sam; Chang, Joon; Kim, Se Kyu; kang, youngae; Jung, Ji Ye; Lee, Kyung Jong; Son, Ji Young; Kim, Eun Young; Lim, Ju Eun; Park, Moo Suk.

In: Journal of Critical Care, Vol. 26, No. 3, 01.06.2011, p. 241-248.

Research output: Contribution to journalArticle

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AU - Park, Byung Hoon

AU - Kim, Young Sam

AU - Chang, Joon

AU - Kim, Se Kyu

AU - kang, youngae

AU - Jung, Ji Ye

AU - Lee, Kyung Jong

AU - Son, Ji Young

AU - Kim, Eun Young

AU - Lim, Ju Eun

AU - Park, Moo Suk

PY - 2011/6/1

Y1 - 2011/6/1

N2 - 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 H2O, followed by stepwise decrement of positive end-expiratory pressure level by 2 cm H2O). Patients who showed a PaO2/FiO2 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.

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