The level of Brain natriuretic Peptide as a Predictor of the Postoperative Period at Operations with Artificial Blood circulation

Abstract

The level of natriuretic peptide is regarded as a prognostic predictor of postoperative heart failure in modern cardiac surgery, and moreover, this hormone is included in the standards of its early diagnosis around the world. This study was conducted at the Irkutsk Cardiac Surgery Center. The results of treatment of 78 patients were analyzed in order to determine the relationship between the dynamics of brain natriuretic peptides and the course of the early postoperative period in operations with artificial cardiopulmonary bypass. Patients were divided into three groups according to the level of natriuretic peptide elevation in the postoperative period. The study proved the dependence of the postoperative period on the multiplicity of the increase in the level of natriuretic peptide B-type.It was found that the higher the rate of increase in the hormone, the lower the numbers of the cardiac index in the postoperative period, longer duration of inotropic support (p > 0.05) and higher doses of adrenomimetics (p > 0.05). The duration of mechanical ventilation was also longer in the groups where a high level of natriuretic peptide was recorded (p > 0.05). Thus, the multiplicity of natriuretic peptide elevation can be a prognostic criterion for the postoperative period in cardiac patients. It is important to note that a single determination of the level of natriuretic peptide should not be used as a marker of postoperative heart failure and this study confirmed the necessity to monitor the dynamics of brain natriuretic peptide’s level in the perioperative period in patients operated with extracorporeal cardiopulmonary bypass.

Keywords

• brain natriuretic peptide
• cardiopulmonary bypass
• inotropic support
• dynamics of brain natriuretic peptide’s level