High levels of B-type natriuretic peptide predict weaning failure from mechanical ventilation in adult patients after cardiac surgery
Autor(a) principal: | |
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Data de Publicação: | 2013 |
Outros Autores: | , , , , , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Clinics |
Texto Completo: | https://www.revistas.usp.br/clinics/article/view/52313 |
Resumo: | OBJECTIVE: The failure to wean from mechanical ventilation is related to worse outcomes after cardiac surgery. The aim of this study was to evaluate whether the serum level of B-type natriuretic peptide is a predictor of weaning failure from mechanical ventilation after cardiac surgery. METHODS: We conducted a prospective, observational cohort study of 101 patients who underwent on-pump coronary artery bypass grafting. B-type natriuretic peptide was measured postoperatively after intensive care unit admission and at the end of a 60-min spontaneous breathing test. The demographic data, hemodynamic and respiratory parameters, fluid balance, need for vasopressor or inotropic support, and length of the intensive care unit and hospital stays were recorded. Weaning failure was considered as either the inability to sustain spontaneous breathing after 60 min or the need for reintubation within 48 h. RESULTS: Of the 101 patients studied, 12 patients failed the weaning trial. There were no differences between the groups in the baseline or intraoperative characteristics, including left ventricular function, EuroSCORE and lengths of the cardiac procedure and cardiopulmonary bypass. The B-type natriuretic peptide levels were significantly higher at intensive care unit admission and at the end of the breathing test in the patients with weaning failure compared with the patients who were successfully weaned. In a multivariate model, a high B-type natriuretic peptide level at the end of a spontaneous breathing trial was the only independent predictor of weaning failure from mechanical ventilation. CONCLUSIONS: A high B-type natriuretic peptide level is a predictive factor for the failure to wean from mechanical ventilation after cardiac surgery. These findings suggest that optimizing ventricular function should be a goal during the perioperative period. |
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Clinics |
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High levels of B-type natriuretic peptide predict weaning failure from mechanical ventilation in adult patients after cardiac surgery B-Type Natriuretic PeptideCardiac SurgeryMechanical VentilationWeaning Failure OBJECTIVE: The failure to wean from mechanical ventilation is related to worse outcomes after cardiac surgery. The aim of this study was to evaluate whether the serum level of B-type natriuretic peptide is a predictor of weaning failure from mechanical ventilation after cardiac surgery. METHODS: We conducted a prospective, observational cohort study of 101 patients who underwent on-pump coronary artery bypass grafting. B-type natriuretic peptide was measured postoperatively after intensive care unit admission and at the end of a 60-min spontaneous breathing test. The demographic data, hemodynamic and respiratory parameters, fluid balance, need for vasopressor or inotropic support, and length of the intensive care unit and hospital stays were recorded. Weaning failure was considered as either the inability to sustain spontaneous breathing after 60 min or the need for reintubation within 48 h. RESULTS: Of the 101 patients studied, 12 patients failed the weaning trial. There were no differences between the groups in the baseline or intraoperative characteristics, including left ventricular function, EuroSCORE and lengths of the cardiac procedure and cardiopulmonary bypass. The B-type natriuretic peptide levels were significantly higher at intensive care unit admission and at the end of the breathing test in the patients with weaning failure compared with the patients who were successfully weaned. In a multivariate model, a high B-type natriuretic peptide level at the end of a spontaneous breathing trial was the only independent predictor of weaning failure from mechanical ventilation. CONCLUSIONS: A high B-type natriuretic peptide level is a predictive factor for the failure to wean from mechanical ventilation after cardiac surgery. These findings suggest that optimizing ventricular function should be a goal during the perioperative period. Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo2013-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/clinics/article/view/5231310.6061/clinics/2013(01)OA05Clinics; Vol. 68 No. 1 (2013); 33-38 Clinics; v. 68 n. 1 (2013); 33-38 Clinics; Vol. 68 Núm. 1 (2013); 33-38 1980-53221807-5932reponame:Clinicsinstname:Universidade de São Paulo (USP)instacron:USPenghttps://www.revistas.usp.br/clinics/article/view/52313/56340Lara, Thiago MartinsHajjar, Ludhmila AbrahaoAlmeida, Juliano Pinheiro deFukushima, Julia TizueBarbas, Carmem Silvia ValenteRodrigues, Adriano Rogerio BaldacinNozawa, EmiliaFeltrim, Maria Ignes ZanettiAlmeida, ElisangelaCoimbra, VeraOsawa, EduardoIanotti, Rafael de MoraesLeme, Alcino CostaJatene, Fabio BiscegliAuler-Jr., Jose Otavio CostaGalas, Filomena Regina Barbosa Gomesinfo:eu-repo/semantics/openAccess2013-03-09T14:08:18Zoai:revistas.usp.br:article/52313Revistahttps://www.revistas.usp.br/clinicsPUBhttps://www.revistas.usp.br/clinics/oai||clinics@hc.fm.usp.br1980-53221807-5932opendoar:2013-03-09T14:08:18Clinics - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
High levels of B-type natriuretic peptide predict weaning failure from mechanical ventilation in adult patients after cardiac surgery |
title |
High levels of B-type natriuretic peptide predict weaning failure from mechanical ventilation in adult patients after cardiac surgery |
spellingShingle |
High levels of B-type natriuretic peptide predict weaning failure from mechanical ventilation in adult patients after cardiac surgery Lara, Thiago Martins B-Type Natriuretic Peptide Cardiac Surgery Mechanical Ventilation Weaning Failure |
title_short |
High levels of B-type natriuretic peptide predict weaning failure from mechanical ventilation in adult patients after cardiac surgery |
title_full |
High levels of B-type natriuretic peptide predict weaning failure from mechanical ventilation in adult patients after cardiac surgery |
title_fullStr |
High levels of B-type natriuretic peptide predict weaning failure from mechanical ventilation in adult patients after cardiac surgery |
title_full_unstemmed |
High levels of B-type natriuretic peptide predict weaning failure from mechanical ventilation in adult patients after cardiac surgery |
title_sort |
High levels of B-type natriuretic peptide predict weaning failure from mechanical ventilation in adult patients after cardiac surgery |
author |
Lara, Thiago Martins |
author_facet |
Lara, Thiago Martins Hajjar, Ludhmila Abrahao Almeida, Juliano Pinheiro de Fukushima, Julia Tizue Barbas, Carmem Silvia Valente Rodrigues, Adriano Rogerio Baldacin Nozawa, Emilia Feltrim, Maria Ignes Zanetti Almeida, Elisangela Coimbra, Vera Osawa, Eduardo Ianotti, Rafael de Moraes Leme, Alcino Costa Jatene, Fabio Biscegli Auler-Jr., Jose Otavio Costa Galas, Filomena Regina Barbosa Gomes |
author_role |
author |
author2 |
Hajjar, Ludhmila Abrahao Almeida, Juliano Pinheiro de Fukushima, Julia Tizue Barbas, Carmem Silvia Valente Rodrigues, Adriano Rogerio Baldacin Nozawa, Emilia Feltrim, Maria Ignes Zanetti Almeida, Elisangela Coimbra, Vera Osawa, Eduardo Ianotti, Rafael de Moraes Leme, Alcino Costa Jatene, Fabio Biscegli Auler-Jr., Jose Otavio Costa Galas, Filomena Regina Barbosa Gomes |
author2_role |
author author author author author author author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Lara, Thiago Martins Hajjar, Ludhmila Abrahao Almeida, Juliano Pinheiro de Fukushima, Julia Tizue Barbas, Carmem Silvia Valente Rodrigues, Adriano Rogerio Baldacin Nozawa, Emilia Feltrim, Maria Ignes Zanetti Almeida, Elisangela Coimbra, Vera Osawa, Eduardo Ianotti, Rafael de Moraes Leme, Alcino Costa Jatene, Fabio Biscegli Auler-Jr., Jose Otavio Costa Galas, Filomena Regina Barbosa Gomes |
dc.subject.por.fl_str_mv |
B-Type Natriuretic Peptide Cardiac Surgery Mechanical Ventilation Weaning Failure |
topic |
B-Type Natriuretic Peptide Cardiac Surgery Mechanical Ventilation Weaning Failure |
description |
OBJECTIVE: The failure to wean from mechanical ventilation is related to worse outcomes after cardiac surgery. The aim of this study was to evaluate whether the serum level of B-type natriuretic peptide is a predictor of weaning failure from mechanical ventilation after cardiac surgery. METHODS: We conducted a prospective, observational cohort study of 101 patients who underwent on-pump coronary artery bypass grafting. B-type natriuretic peptide was measured postoperatively after intensive care unit admission and at the end of a 60-min spontaneous breathing test. The demographic data, hemodynamic and respiratory parameters, fluid balance, need for vasopressor or inotropic support, and length of the intensive care unit and hospital stays were recorded. Weaning failure was considered as either the inability to sustain spontaneous breathing after 60 min or the need for reintubation within 48 h. RESULTS: Of the 101 patients studied, 12 patients failed the weaning trial. There were no differences between the groups in the baseline or intraoperative characteristics, including left ventricular function, EuroSCORE and lengths of the cardiac procedure and cardiopulmonary bypass. The B-type natriuretic peptide levels were significantly higher at intensive care unit admission and at the end of the breathing test in the patients with weaning failure compared with the patients who were successfully weaned. In a multivariate model, a high B-type natriuretic peptide level at the end of a spontaneous breathing trial was the only independent predictor of weaning failure from mechanical ventilation. CONCLUSIONS: A high B-type natriuretic peptide level is a predictive factor for the failure to wean from mechanical ventilation after cardiac surgery. These findings suggest that optimizing ventricular function should be a goal during the perioperative period. |
publishDate |
2013 |
dc.date.none.fl_str_mv |
2013-01-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/clinics/article/view/52313 10.6061/clinics/2013(01)OA05 |
url |
https://www.revistas.usp.br/clinics/article/view/52313 |
identifier_str_mv |
10.6061/clinics/2013(01)OA05 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/clinics/article/view/52313/56340 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo |
publisher.none.fl_str_mv |
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo |
dc.source.none.fl_str_mv |
Clinics; Vol. 68 No. 1 (2013); 33-38 Clinics; v. 68 n. 1 (2013); 33-38 Clinics; Vol. 68 Núm. 1 (2013); 33-38 1980-5322 1807-5932 reponame:Clinics instname:Universidade de São Paulo (USP) instacron:USP |
instname_str |
Universidade de São Paulo (USP) |
instacron_str |
USP |
institution |
USP |
reponame_str |
Clinics |
collection |
Clinics |
repository.name.fl_str_mv |
Clinics - Universidade de São Paulo (USP) |
repository.mail.fl_str_mv |
||clinics@hc.fm.usp.br |
_version_ |
1800222759682310144 |