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Intensive Care Medicine

, Volume 32, Issue 10, pp 1529–1536 | Cite as

B-type natriuretic peptide and weaning from mechanical ventilation

  • Armand Mekontso-DessapEmail author
  • Nicolas de Prost
  • Emmanuelle Girou
  • François Braconnier
  • François Lemaire
  • Christian Brun-Buisson
  • Laurent Brochard
Original

Abstract

Objective

Cardiac function and volume status could play a critical role in the setting of weaning failure. B-type natriuretic peptide (BNP) is a powerful marker of cardiac dysfunction. We assessed the value of BNP during the weaning process.

Design, setting and patients

One hundred and two consecutive patients considered ready to undergo a 1-h weaning trial (T-piece or low-pressure support level) were prospectively included in a medical intensive care unit of a university hospital. Weaning was considered successful if the patient passed the trial and sustained spontaneous breathing for more than 48 h after extubation.

Interventions

Plasma BNP was measured just before the trial in all patients, and at the end of the trial in the first 60 patients.

Results

Overall, 42 patients (41.2%) failed the weaning process (37 patients failed the trial and 5 failed extubation). Logistic regression analysis identified high BNP level before the trial and the product of airway pressure and breathing frequency during ventilation as independent risk factors for weaning failure. BNP values were not different at the end of the trial. In nine of the patients in whom the weaning process failed, it succeeded on a later occasion after diuretic therapy. Their BNP level before weaning decreased between the two attempts (517 vs 226 pg/ml, p = 0.01). In survivors, BNP level was significantly correlated to weaning duration (rho = 0.52, p < 0.01).

Conclusions

Baseline plasma BNP level before the first weaning attempt is higher in patients with subsequent weaning failure and correlates to weaning duration.

Keywords

Cardiac insufficiency B-type natriuretic peptide Artificial respiration Spontaneous breathing trial Extubation 

Supplementary material

134_2006_339_MOESM1_ESM.doc (61 kb)
Electronic Supplementary Material (DOC 61K)

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Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Armand Mekontso-Dessap
    • 1
    • 4
    Email author
  • Nicolas de Prost
    • 1
  • Emmanuelle Girou
    • 2
  • François Braconnier
    • 3
  • François Lemaire
    • 1
  • Christian Brun-Buisson
    • 1
  • Laurent Brochard
    • 1
    • 4
  1. 1.Medical Intensive Care Unit, Centre Hospitalo-Universitaire Henri MondorAssistance Publique-Hôpitaux de Paris, Université Paris XIICréteil CedexFrance
  2. 2.Infection Control Unit, Centre Hospitalo-Universitaire Henri MondorAssistance Publique-Hôpitaux de Paris, Université Paris XIICréteil CedexFrance
  3. 3.Biochemistry Laboratory, Centre Hospitalo-Universitaire Henri MondorAssistance Publique-Hôpitaux de Paris, Université Paris XIICréteil CedexFrance
  4. 4.INSERM U 651, Centre Hospitalo-Universitaire Henri MondorAssistance Publique-Hôpitaux de Paris, Université Paris XIICréteil CedexFrance

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