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Plasma B-type natriuretic peptide (BNP) variation in multi-trauma patients

  • Prospective Clinical Study
  • Published:
Hellenic Journal of Surgery

Abstract

Aim

To study plasma B-type natriuretic peptide BNP) variation in adult multi-trauma patients and to correlate BNP levels with the class of haemorrhagic shock and the amount of fluids received during resuscitation.

Method

Multi-trauma patients (class II–III haemorrhagic shock) without brain injury were included and their plasma BNP level was measured at 24 and 72 hours.

Results

Twenty-one adult patients with no previous heart disease were included in the study. BNP levels >500 pg/ml were not observed, 9 were < 5.0 pg/ml (undetectable), 24 within normal limits (5.0–100 pg/ ml) and 7 slightly above normal (>100 pg/ml). BNP levels were within normal range in most patients at 24 (81%) and 72 hours (86%).

Conclusions

Multi-trauma patients with no brain injury are able to handle the amount of volume infused at resuscitation without statistically significant elevation of BNP levels. We found no difference between BNP levels in class II and class III shock in adult multi-trauma patients.

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References

  1. Beekley AC. Damage control resuscitation: a sensible approach to the exsanguinating surgical patient. Crit Care Med. 2008 Jul;36(7 Suppl): S267–S274.

    Article  PubMed  Google Scholar 

  2. Sihler KC, Napolitano LM. Complications of massive transfusion. Chest 2010 Jan; 137(1):209–220.

    Article  PubMed  Google Scholar 

  3. Zakaria el R, Tsakadze NL, Garrison RN: Hypertonic saline resuscitation improves intestinal microcirculation in a rat model of hemorrhagic shock. Surgery, 2006 Oct;140(4):579–588.

    Article  PubMed  Google Scholar 

  4. De Bold A (1985). “Atrial natriuretic factor: a hormone produced by the heart” Science 230(4727):767–770.

    Article  PubMed  Google Scholar 

  5. Atisha D, Bhalla MA, Morrison LK et al: A prospective study in search of an optimal B-natriuretic peptide level to screen patients for cardiac dysfunction. Am Heart J 2004 Sep;148(3):518–523.

    Article  PubMed  CAS  Google Scholar 

  6. Kirchhoff C, Stegmaier J, Bogner V et al: Intrathecal and systemic concentration of NT-pro BNP in patients with severe traumatic brain injury. J Neurotrauma. 2006 Jun;23(6):943–949.

    Article  PubMed  Google Scholar 

  7. A.T.L.S. American College of Surgeons — Committee on Trauma 6th edition — 3rd chapter «shock».

  8. Bickell WH, Wall MJ, Pepe PE et al: Immediate versus delayed fluid resuscitation for hypotensive patients with penetrating torso injuries. N Eng J Med 1994; 331:1105–1109.

    Article  CAS  Google Scholar 

  9. Battlefield Advanced Trauma Life Support (3ed.). Joint Services Publication 570, 2006.

  10. Holcomb JB, Wade CE, Michalek JE et al: Increased plasma and platelet to red blood cell ratios improves outcome in 466 massively transfused civilian trauma patients. Ann Surg. 2008 Sep;248(3):447–458.

    PubMed  Google Scholar 

  11. Baker AJ, Rhind SG, Morrison LJ et al: Resuscitation with hypertonic saline -dextran reduces serum biomarker levels and correlates with outcome in severe traumatic brain injury patients. J Neurotrauma 2009 Aug; 26(8): 1227–1240.

    Article  PubMed  Google Scholar 

  12. Crookes BA, Cohn SM, Bonet H et al: Building a better fluid for emergency resuscitation of traumatic brain injury. J Trauma 2004 Sep;57(3):547–554.

    Article  PubMed  Google Scholar 

  13. Galinska A, Hatch V, Craig R et al: The C terminus of cardiac troponin I stabilizes the Ca2+- activated state of tropomyosin on actin filaments. Circ Res. 2010 Mar 5;106(4):705–711.

    Article  Google Scholar 

  14. Levin ER, Gardner DG, Samson WK. Natriuretic peptides. N Engl J Med 1998; 339:321–328.

    Article  PubMed  CAS  Google Scholar 

  15. De Bold AJ, Bruneau BG, Kuroski de Bold ML: Mechanical and neuroendocrine regulation of the endocrine heart. Cardiovasc Res 1996 Jan;31(1):7–18.

    Article  PubMed  Google Scholar 

  16. Sviri GE, Soustiel JF, Zaaroor M: Alteration in brain natriuretic peptide (BNP) plasma concentration following severe traumatic brain injury. Acta Neurichir (Wien) 2006;148(5):529–533.

    Article  CAS  Google Scholar 

  17. Brenden CK, Hollander JE, Guss D et al: Gray zone BNP levels in heart failure patients in the emergency department: results from the Rapid Emergency Department Heart Failure Outpatient Trial multicenter study. Am Heart J. 2006 May; 151(5):1006–1011.

    Article  PubMed  CAS  Google Scholar 

  18. Tsuchida K, Tanabe K: Influence of paroxysmal atrial fibrillation on brain natriuretic peptide secretion. J Cardiol. 2004 Jul;44(1):1–11.

    PubMed  Google Scholar 

  19. Tsutamoto T, Wada A, Sakai H et al: Relationship between renal function and plasma brain natriuretic peptide in patients with heart failure. J Am Coll Cardiol. 2006 Feb 7;47(3):582–586.

    Article  Google Scholar 

  20. Wang TJ, Larson MG, Levy D et al: Impact of obesity on plasma natriuretic peptide levels. Circulation. 2004 Feb 10;109(75):594–600.

    Article  Google Scholar 

  21. Kia M, Cooley A, Rimmer G et al: The efficacy of B-type natriuretic study for early identification of blood loss in traumatic injury. Am J surg 2006 Mar;19(3):353–357.

    Article  Google Scholar 

  22. Kirchhoff C, Leidel BA, Kirchhoff S et al: Analysis of Nterminal pro-B-type natriuretic peptide and cardiac index in multiple injured patients: a prospective cohort study. Crit Care 2008;12(5): R 118.

    Article  Google Scholar 

  23. Stewart D, Waxman K, Brown CA et al: B-type natriuretic peptide levels may be elevated in the critically injured trauma patient without congestive heart failure. J trauma 2007 Oct;63(4):747–750.

    Article  PubMed  CAS  Google Scholar 

  24. Friese RS, Dineen S, Jennings A et al: Serum B- type natriuretic peptide: a marker of fluid resuscitation after injury? J Trauma 2007 Jun;62(6):1346–1350.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. 2nd Surgical Departmet, Nikaia General Hospital Piraeus, Piraeus, Greece

    P. Bouras, A. Rogdakis, N. El-Fellach, B. Karampas & S. Pinis

  2. Biochemistry Lab, Nikaia General Hospital Piraeus, Piraeus, Greece

    G. Liakos, B. Mavrodakou & M. Papaioannou

Authors
  1. P. Bouras
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  2. A. Rogdakis
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  3. N. El-Fellach
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  4. B. Karampas
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  5. G. Liakos
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  6. B. Mavrodakou
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  7. M. Papaioannou
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  8. S. Pinis
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Correspondence to P. Bouras.

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Bouras, P., Rogdakis, A., El-Fellach, N. et al. Plasma B-type natriuretic peptide (BNP) variation in multi-trauma patients. Hellenic J Surg 83, 202–209 (2011). https://doi.org/10.1007/s13126-011-0039-9

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  • DOI: https://doi.org/10.1007/s13126-011-0039-9

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