Prognostic value of natriuretic peptides in severe trauma patients with multiple organ dysfunction syndrome

Li,Nan; Song,Zhi; Wang,Jing; Teng,Yue; Cui,Yan; Jin,Hongxu; Gao,Yan

doi:10.3892/etm.2015.2570

August-2015 Volume 10 Issue 2

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August-2015 Volume 10 Issue 2

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Article

Prognostic value of natriuretic peptides in severe trauma patients with multiple organ dysfunction syndrome

Authors:
- Nan Li
- Zhi Song
- Jing Wang
- Yue Teng
- Yan Cui
- Hongxu Jin
- Yan Gao
View Affiliations / Copyright

Affiliations: Department of Emergency Medicine, General Hospital of Shenyang Military Region, Shenyang, Liaoning 110016, P.R. China
Pages: 792-796
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Published online on: June 11, 2015

https://doi.org/10.3892/etm.2015.2570
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Abstract

The aim of the present study was to evaluate the prognostic values of the N‑terminal peptide of pro‑atrial natriuretic peptide (NT‑proANP) and the N‑terminal fragment of B‑type natriuretic peptide (NT‑proBNP) in severe trauma patients developing multiple organ dysfunction syndrome (MODS). Out of the 126 severe trauma patients that were admitted to the Emergency Intensive Care Unit of the General Hospital of Shenyang Military Region between January 2009 and December 2011, 26 patients with multiple injuries and an injury severity score (ISS) of >16 points were included in the study. The MODS score was calculated on admission as well as 24, 48 and 72 h after the injury. Patients were divided into two groups: Group A consisted of patients with minor signs of organ dysfunction (MODS score, ≤4 points) and group B of patients with major organ dysfunction (MODS score, >4 points). Venous blood (5 ml) was extracted from the patients on admission and 6, 12, 24, 48 and 72 h after the injury. The Elecsys proBNP® and proANP® assays were used to determine the NT‑proBNP and NT‑proANP levels, respectively. The changes in the levels of C‑reactive protein, white blood cells and neutrophils were detected and analyzed on admission. Acute physiology and chronic health evaluation Ⅱ scores and ISSs were collected 72 h after the injury. The hemodynamic monitoring of cardiac index (CI) was performed using The Pulse index Continuous Cardiac Output system. The serum NT‑proANP and NT‑proBNP concentrations were elevated in all 26 patients. Upon admission, the serum NT‑proANP and NT‑proBNP values were 637.3±8.9 and 137.3±8.9 pmol/l, respectively, in group A and 1,185.0±7.2 and 185.0±7.2 pmol/l, respectively, in group B. The NT‑proANP and NT‑proBNP levels in group A were significantly lower than those in group B at all subsequent time‑points (P<0.001). By contrast, the CI in group A was significantly higher than that in group B at all time‑points (P<0.001). An inverse correlation was observed between the NT‑proANP or NT‑proBNP concentration and CI at 24, 48 and 72 h after the injury (r=‑0.679 and ‑0.772, respectively; P<0.001). In conclusion, the serum NT‑proANP and NT‑proBNP concentrations following multiple injuries have been found to be significantly correlated with the clinical signs of MODS, and a distinct correlation has been observed between the levels of serums NT‑proANP and NT‑proBNP and decreased CI. The data of this pilot study suggest that NT‑proANP and NT‑proBNP levels may be of value in the diagnosis of post‑traumatic cardiac impairment.

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1	Brongel L: Guidelines for severe multiple and multiorgan traumatic injuries. Przegl Lek. 60:(60 Suppl 7). 56–62. 2003.(In Polish). PubMed/NCBI
2	Zweifach BW, Benacerraf B and Thomas L: The relationship between the vascular manifestations of shock produced by endotoxin, trauma, and hemorrhage. II. The possible role of the reticulo-endothelial system in resistance to each type of shock. J Exp Med. 106:403–414. 1957. View Article : Google Scholar : PubMed/NCBI
3	Zweifach BW and Thomas L: The relationship between the vascular manifestations of shock produced by endotoxin, trauma, and hemorrhage. I. Certain similarities between the reactions in normal and endotoxin-tolerant rats. J Exp Med. 106:385–401. 1957. View Article : Google Scholar : PubMed/NCBI
4	Freeman BD, Machado FS, Tanowitz HB and Desruisseaux MS: Endothelin-1 and its role in the pathogenesis of infectious diseases. Life Sci. 118:110–119. 2014. View Article : Google Scholar : PubMed/NCBI
5	Li P, Guo Y, Bledsoe G, Yang ZR, Fan H, Chao L and Chao J: Kallistatin treatment attenuates lethality and organ injury in mouse models of established sepsis. Crit Care. 19:2002015. View Article : Google Scholar : PubMed/NCBI
6	Determann RM, Royakkers AA, Schaefers J, de Boer AM, Binnekade JM, van Straalen JP and Schultz MJ: Serum levels of N-terminal proB-type natriuretic peptide in mechanically ventilated critically ill patients - Relation to tidal volume size and development of acute respiratory distress syndrome. BMC Pulm Med. 13:422013. View Article : Google Scholar : PubMed/NCBI
7	Papanikolaou J, Makris D, Mpaka M, Palli E, Zygoulis P and Zakynthinos E: New insights into the mechanisms involved in B-type natriuretic peptide elevation and its prognostic value in septic patients. Crit Care. 18:R942014. View Article : Google Scholar : PubMed/NCBI
8	Chopra S, Cherian D, Verghese PP and Jacob JJ: Physiology and clinical significance of natriuretic hormones. Indian J Endocrinol Metab. 17:83–90. 2013. View Article : Google Scholar : PubMed/NCBI
9	Siemiatkowski A and Jabłonowska A: Natriuretic peptides - relevance in intensive care. Anestezjol Intens Ter. 40:96–102. 2008.(In Polish). PubMed/NCBI
10	Roger F Shere-Wolfe, Samuel M Galvagno Jr, Thomas E Grissom, et al: Critical care considerations in the management of the trauma patient following initial resuscitation. Scand J Trauma Resusc Emerg Med. 20:682012. View Article : Google Scholar : PubMed/NCBI
11	Hoffmann U and Brueckmann M: A new language of natriuretic peptides in sepsis? Crit Care Med. 36:2686–2687. 2008. View Article : Google Scholar : PubMed/NCBI
12	Kotanidou A, Karsaliakos P, Tzanela M, et al: Prognostic importance of increased plasma amino-terminal pro-brain natriuretic peptide levels in a large noncardiac, general intensive care unit population. Shock. 31:342–347. 2009. View Article : Google Scholar : PubMed/NCBI
13	Mitaka C, Hirata Y, Nagura T, et al: Increased plasma concentrations of brain natriuretic peptide in patients with acute lung injury. J Crit Care. 12:66–71. 1997. View Article : Google Scholar : PubMed/NCBI
14	Behnke BJ, Zawieja DC, Gashev AA, et al: Diminished mesenteric vaso- and venoconstriction and elevated plasma ANP and BNP with simulated microgravity. J Appl Physiol (1985). 104:1273–1280. 2008. View Article : Google Scholar : PubMed/NCBI
15	Castelli GP, Pognani C, Cita M, et al: Procalcitonin, C-reactive protein, white blood cells and SOFA score in ICU: Diagnosis and monitoring of sepsis. Minerva Anestesiol. 72:69–80. 2006.PubMed/NCBI
16	Barati M, Alinejad F, Bahar MA, et al: Comparison of WBC, ESR, CRP and PCT serum levels in septic and non-septic burn cases. Burns. 34:770–774. 2008. View Article : Google Scholar : PubMed/NCBI
17	Yucel T, Memiş D, Karamanlioglu B, et al: The prognostic value of atrial and brain natriuretic peptides, troponin I and C-reactive protein in patients with sepsis. Exp Clin Cardiol. 13:183–188. 2008.PubMed/NCBI
18	Yucel T, Memiş D, Karamanlioglu B, Süt N and Yuksel M: The prognostic value of atrial and brain natriuretic peptides, troponin I and C-reactive protein in patients with sepsis. Exp Clin Cardiol. 13:183–188. 2008.PubMed/NCBI
19	Konarzewski W: Pulmonary artery catheterisation. Pulmonary artery catheters should be banned from intensive care units. BMJ. 313:13281996. View Article : Google Scholar : PubMed/NCBI
20	Simini B: Pulmonary artery catheters in intensive care. Lancet. 366:435–436. 2005. View Article : Google Scholar : PubMed/NCBI

Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Prognostic value of natriuretic peptides in severe trauma patients with multiple organ dysfunction syndrome

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