Cautious application of pleural N-terminal pro-B-type natriuretic peptide in diagnosis of congestive heart failure pleural effusions among critically ill patients.
Several studies on diagnostic accuracy of pleural N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) for effusions from congestive heart failure (CHF) conclude that pleural NT-pro-BNP is a useful biomarker with high diagnostic accuracy for distinguishing CHF effusions. However, its applicability...
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doaj-606f9ff6d07e40ebb4b625f7262900672020-11-24T21:49:08ZengPublic Library of Science (PLoS)PLoS ONE1932-62032014-01-01912e11530110.1371/journal.pone.0115301Cautious application of pleural N-terminal pro-B-type natriuretic peptide in diagnosis of congestive heart failure pleural effusions among critically ill patients.Jiann-Horng YehChun-Ta HuangChia-Hsiung LiuSheng-Yuan RuanYi-Ju TsaiYing-Chun ChienChing-Yao YangChing-Yao YangChun-Kai HuangChia-Lin HsuLu-Cheng KuoPei-Lin LeeShih-Chi KuPing-Hung KuoChong-Jen YuHINT Study GroupSeveral studies on diagnostic accuracy of pleural N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) for effusions from congestive heart failure (CHF) conclude that pleural NT-pro-BNP is a useful biomarker with high diagnostic accuracy for distinguishing CHF effusions. However, its applicability in critical care settings remains uncertain and requires further investigations.NT-proBNP was measured in pleural fluid samples of a prospective cohort of intensive care unit patients with pleural effusions. Receiver operating characteristic curve analysis was performed to determine diagnostic accuracy of pleural NT-proBNP for prediction of CHF effusions.One hundred forty-seven critically ill patients were evaluated, 38 (26%) with CHF effusions and 109 (74%) with non-CHF effusions of various causes. Pleural NT-proBNP levels were significantly elevated in patients with CHF effusions. Pleural NT-pro-BNP demonstrated the area under the curve of 0.87 for diagnosing effusions due to CHF. With a cutoff of 2200 pg/mL, pleural NT-proBNP displayed high sensitivity (89%) but moderate specificity (73%). Notably, 29 (27%) of 109 patients with non-CHF effusions had pleural NT-proBNP levels >2200 pg/mL and these patients were more likely to experience septic shock (18/29 vs. 10/80, P<0.001) or acute kidney injury (19/29 vs. 9/80, P<0.001).Among critically ill patients, pleural NT-proBNP measurements remain a useful diagnostic aid in evaluation of pleural effusions. However, patients with non-CHF effusions may exhibit high pleural NT-proBNP concentrations if they suffer from septic shock or acute kidney injury. Accordingly, it is suggested that clinical context should be taken into account when interpreting pleural NT-proBNP values in critical care settings.http://europepmc.org/articles/PMC4264949?pdf=render |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jiann-Horng Yeh Chun-Ta Huang Chia-Hsiung Liu Sheng-Yuan Ruan Yi-Ju Tsai Ying-Chun Chien Ching-Yao Yang Ching-Yao Yang Chun-Kai Huang Chia-Lin Hsu Lu-Cheng Kuo Pei-Lin Lee Shih-Chi Ku Ping-Hung Kuo Chong-Jen Yu HINT Study Group |
spellingShingle |
Jiann-Horng Yeh Chun-Ta Huang Chia-Hsiung Liu Sheng-Yuan Ruan Yi-Ju Tsai Ying-Chun Chien Ching-Yao Yang Ching-Yao Yang Chun-Kai Huang Chia-Lin Hsu Lu-Cheng Kuo Pei-Lin Lee Shih-Chi Ku Ping-Hung Kuo Chong-Jen Yu HINT Study Group Cautious application of pleural N-terminal pro-B-type natriuretic peptide in diagnosis of congestive heart failure pleural effusions among critically ill patients. PLoS ONE |
author_facet |
Jiann-Horng Yeh Chun-Ta Huang Chia-Hsiung Liu Sheng-Yuan Ruan Yi-Ju Tsai Ying-Chun Chien Ching-Yao Yang Ching-Yao Yang Chun-Kai Huang Chia-Lin Hsu Lu-Cheng Kuo Pei-Lin Lee Shih-Chi Ku Ping-Hung Kuo Chong-Jen Yu HINT Study Group |
author_sort |
Jiann-Horng Yeh |
title |
Cautious application of pleural N-terminal pro-B-type natriuretic peptide in diagnosis of congestive heart failure pleural effusions among critically ill patients. |
title_short |
Cautious application of pleural N-terminal pro-B-type natriuretic peptide in diagnosis of congestive heart failure pleural effusions among critically ill patients. |
title_full |
Cautious application of pleural N-terminal pro-B-type natriuretic peptide in diagnosis of congestive heart failure pleural effusions among critically ill patients. |
title_fullStr |
Cautious application of pleural N-terminal pro-B-type natriuretic peptide in diagnosis of congestive heart failure pleural effusions among critically ill patients. |
title_full_unstemmed |
Cautious application of pleural N-terminal pro-B-type natriuretic peptide in diagnosis of congestive heart failure pleural effusions among critically ill patients. |
title_sort |
cautious application of pleural n-terminal pro-b-type natriuretic peptide in diagnosis of congestive heart failure pleural effusions among critically ill patients. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2014-01-01 |
description |
Several studies on diagnostic accuracy of pleural N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) for effusions from congestive heart failure (CHF) conclude that pleural NT-pro-BNP is a useful biomarker with high diagnostic accuracy for distinguishing CHF effusions. However, its applicability in critical care settings remains uncertain and requires further investigations.NT-proBNP was measured in pleural fluid samples of a prospective cohort of intensive care unit patients with pleural effusions. Receiver operating characteristic curve analysis was performed to determine diagnostic accuracy of pleural NT-proBNP for prediction of CHF effusions.One hundred forty-seven critically ill patients were evaluated, 38 (26%) with CHF effusions and 109 (74%) with non-CHF effusions of various causes. Pleural NT-proBNP levels were significantly elevated in patients with CHF effusions. Pleural NT-pro-BNP demonstrated the area under the curve of 0.87 for diagnosing effusions due to CHF. With a cutoff of 2200 pg/mL, pleural NT-proBNP displayed high sensitivity (89%) but moderate specificity (73%). Notably, 29 (27%) of 109 patients with non-CHF effusions had pleural NT-proBNP levels >2200 pg/mL and these patients were more likely to experience septic shock (18/29 vs. 10/80, P<0.001) or acute kidney injury (19/29 vs. 9/80, P<0.001).Among critically ill patients, pleural NT-proBNP measurements remain a useful diagnostic aid in evaluation of pleural effusions. However, patients with non-CHF effusions may exhibit high pleural NT-proBNP concentrations if they suffer from septic shock or acute kidney injury. Accordingly, it is suggested that clinical context should be taken into account when interpreting pleural NT-proBNP values in critical care settings. |
url |
http://europepmc.org/articles/PMC4264949?pdf=render |
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