Thursday March 23, 2006
Can BNPs replace Pulmonary Wedge Pressure?
With BNP as a marker of fluid overload on heart, there was a lot of enthuthiasm about using it as a non-invasive mirror for PCWP. Group of physicians from Division of Cardiology, Johns Hopkins Hospital, Baltimore, Maryland studied prospectively 40 patients in the ICU requiring invasive hemodynamic monitoring. Hemodynamics were recorded simultaneously with blood sampling for both BNP and NT-proBNP. They found that due to rapidly fluctuating levels of estimated glomerular filtration rate in ICU patients - BNPs have very poor correlation with PCWP.
Related previous pearls:
BNP or Pro-BNP ? and Re. Nesiritide (Netrecor)
1. Relationship Between B-Type Natriuretic Peptides and Pulmonary Capillary Wedge Pressure in the Intensive Care Unit - J Am Coll Cardiol, 2005; 45:1667-1671