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Natriuretic peptide type B in burn intensive care
Uppsala University, Sweden .
Uppsala University, Sweden .
Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Hand and Plastic Surgery. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Anaesthesiology and Intensive Care in Linköping.
Uppsala University, Sweden .
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2013 (English)In: JOURNAL OF TRAUMA AND ACUTE CARE SURGERY, ISSN 2163-0755, Vol. 74, no 3, 855-861 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The plasma concentration of natriuretic peptide type B (BNP) or NT-proBNP (P-BNP or P-NT-proBNP) reflects cardiac load. In intensive care unit settings and in chronic inflammation, it is also affected by non-heart-related mechanisms. It has been suggested to be a marker of hydration after severe burns and to predict outcome in critically ill patients, but results are contradictory. We therefore measured P-NT-proBNP after severe burns and related it to injury related variables and to organ dysfunction. less thanbrgreater than less thanbrgreater thanMETHODS: Fifty consecutive patients with a burn size greater than 10% were studied for the first 2 weeks. P-NT-proBNP changes were analyzed in relation to burn size, age, changes in body weight, C-reactive protein in plasma, and organ function assessed as Sequential Organ Failure Assessment (SOFA) scores less thanbrgreater than less thanbrgreater thanRESULTS: P-NT-proBNP showed large day-to-day and between patient variations. Daily change in body weight correlated with P-NT-proBNP only on Day 2, when maximum mobilization of edema occurred. Thereafter, P-NT-proBNP correlated with C-reactive protein in plasma as well as with SOFA scores. Burn size correlated with maximal weight change, which in turn correlated with both time for and value of maximum P-NT-proBNP. Maximal P-NT-proBNP was related to mortality and correlated better with SOFA score on Day 14 compared with age and burn size. In linear regressions, together with age at injury and total body surface area, P-NT-proBNP assessed on Days 3 to 8 was an independent predictor for every subsequent SOFA score measured one or more days later up to Day 14. less thanbrgreater than less thanbrgreater thanCONCLUSION: P-NT-proBNP exhibited considerable interindividual and day-to-day variations. Values were related to mortality, burn size, water accumulation, posttraumatic response, and organ function. Maximum P-NT-proBNP correlated stronger with length of stay and with organ function on Day 14, compared with age and burn size. High values in Days 3 through 8 were also independent predictors of subsequent organ function up to 2 weeks after injury. (J Trauma Acute Care Surg. 2013;74: 855-861.

Place, publisher, year, edition, pages
Lippincott, Williams and Wilkins , 2013. Vol. 74, no 3, 855-861 p.
Keyword [en]
Natriuretic peptide type B, burns, stress, intensive care, injury severity
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Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-91014DOI: 10.1097/TA.0b013e31827e154aISI: 000316321900030OAI: oai:DiVA.org:liu-91014DiVA: diva2:615664
Available from: 2013-04-11 Created: 2013-04-11 Last updated: 2014-03-24

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Sjöberg, Folke

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Division of Clinical SciencesFaculty of Health SciencesDepartment of Hand and Plastic SurgeryDepartment of Anaesthesiology and Intensive Care in Linköping
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