The predictive values of B-type natriuretic peptide for the heart function and prognosis in patients with severe sepsis and septic shock

Objective To evaluate the prognosis predictive value of B-type natriuretic peptide (BNP) for heart function and outcome in severe sepsis and septic shock patients. Methods Fifty-four severe sepsis and septic shock patients were studied prospectively. Plasma BNP level and left ventricular ejection fraction (LVEF) were measured when the patients stayed in the intensive care unit (ICU) for 24 hours. The data from clinical feature,28-day mortality,APACHE Ⅱscore and length of stay (LOS) in ICU were collected. The patients were divided into survival group and non-survival group. The survival group was further divided into BNP elevated group and BNP normal group. Results BNP levels were significantly higher in heart dysfunction patients(LVEF50%)than those in heart function normal patients(LVEF≥50%) [(1 268.3±601.5) pg/mL vs (764.6±297.4) pg/mL,P=0.009];BNP levels were significantly higher in non-survivors compared with survivors[(1 574.1±541.4)pg/mL vs (365.2±94.7) pg/mL,P=0.006]. BNP greater than 692.5 pg/mL within the first 24 hours was an independent prognostic indicator of mortality (sensitivity 90.0%,specificity 82.4%). In survival patients,the length of stay in ICU was significantly higher in BNP elevated group than that in BNP normal group [(22.7 ±7.8)days vs (14.0±5.7)days,P=0.02]. Conclusions Plasma BNP level could be used as a reliable marker for identification of patients developing sepsis-induced myocardial depression. Plasma BNP level is a valuable prognostic predictive factor for severe sepsis and septic shock patient.