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Study of the Brain Natriuretic Peptide in blood plasma after pneumonectomy and its role as a predictor of postoperative complications

Abstract

Objectives: The Brain Natriuretic peptide (BNP) is a peptide responsible for the homeostasis of the cardiovascular system. 

In this study, the kinetics of BNP blood plasma levels after pneumonectomy, where certain hemodynamic alterations do occur, are analyzed and a possible predictive value of postoperative complications is examined. 

Methods:  Thirty-five patients enrolled, underwent a scheduled pneumonectomy for non-small cell cancer of the lung.  The BNP plasma levels were recorded pre-operatively, immediately after the ligation of pulmonary artery, at 3 and at 24 hours postoperatively. 

The collected data were analyzed with descriptive statistical analysis, using students t-test Chi-square, ANOVA, and Pearson’s correlation coefficient. The differences considered significant at p < 0.05. 

Results: BNP showed a statistically significant increase after the ligation of the pulmonary artery in all of the patients. The patients were divided into 2 groups according to the presence or not of the complications. In the complications group the BNP increase was significantly greater than in the non-complication group. There is direct correlation of BNP value at 24 hours post-operatively and the occurrence of complications. The cut-off value was set at 100pgr/ml (sensitivity 91,6% and specificity 93.75%). Pre operatively BNP values above 15pgr/ml have 17,41% probability for a complication to occur. (60% sensitivity and 70.83% specificity)

Conclusion: The results of the study of the BNP after pneumonectomy are interesting and are in the path of a safety and economical routine clinical use for the prediction and prevention of post-operative complications. 

 

References

  1. Martinez-Rumayor A, Richards AM, Burnett JC, Januzzi JL Jr. Biology of the natriuretic peptides. Am J Cardiol. 2008 Feb 4;101(3A)
  2. Yamanouchi S, Kudo D, Endo T, et al. Blood N-terminal pro-BNP as a potential indicator of cardiac preload in patients with high volume load. Tohoku J Exp Med. 2010 Jul;221(3):175-80.
  3. Kuwahara K, Nakao K. Regulation and significance of atrial and brain natriuretic peptides as cardiac hormones. Endocr J. 2010;57(7):555-65.
  4. Shields T, Locicero J, Reed C, FeinsR, General Thoracic surgery in lung resections Lippicont Williams and Wilkins 2009: 409.
  5. J Park BH, Kim YS, Chang J, et al. N-terminal pro-brain natriuretic peptide as a marker of right ventriculardysfunction after open-lung approach in patients with acute lung injury/acute respiratory distress syndrome. Crit Care. 2011 Jun;26(3):2418
  6. J Pruszczyk P. N-terminal pro-brain natriuretic peptide as an indicator of right ventricular dysfunction. Card Fail. 2005 Jun;11(5 Suppl):S65-9.
  7. Tayama K(1), Takamori S, Mitsuoka M, et al. Natriuretic peptides after pulmonary resection. Ann Thorac Surg. 2002 May;73(5):1582-6.
  8. Cagini L, Andolfi M, Leli C, et al. B-type natriuretic peptide following thoracic surgery: a predictor of postoperative cardiopulmonary complications. Eur J Cardiothorac Surg. 2014 Nov;46(5):e74-80.
  9. Nojiri T, Maeda H, Takeuchi Y, et al. Predictive value of B-type natriuretic peptide for postoperative atrial fibrillation following pulmonary resection for lung cancer.Eur J Cardiothorac Surg. 2010 Apr;37(4):787-91.
  10. Wang F, Wu Y, Tang L, et al. Brain natriuretic peptide for prediction of mortality in patients with sepsis: a systematic review and meta-analysis. Crit Care. 2012 May 6;16(3):R74.
  11. Nojiri T(1), Inoue M, Shintani Y, et al. B-type natriuretic peptide-guided risk assessment for postoperative complications in lung cancer surgery. M. World J Surg. 2015 May;39(5):1092-8.
  12. Salvatici M, Cardinale D, Spaggiari L, et al.Atrial fibrillation after thoracic surgery for lung cancer: use of a single cut-off value of N-terminal pro-B type natriuretic peptide to identify patients at risk. Biomarkers. 2010 May;15(3):259-65.

How to Cite

Baltayiannis, N., Tsimpinos, M., Grisbolaki, E., Chatzimichalis, A., & Tomos, P. (2018). Study of the Brain Natriuretic Peptide in blood plasma after pneumonectomy and its role as a predictor of postoperative complications. Medicina, 49(2). https://doi.org/10.15562/medicina.v49i2.137

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