NT-proBNP change is useful for predicting weaning failure from invasive mechanical ventilation among postsurgical patients: a retrospective, observational cohort study
Abstract Background To evaluate the predictive value of N-terminal prohormone B-type natriuretic peptide (NTproBNP) for weaning failure among patients undergoing major surgeries during spontaneous breathing trial (SBT), compared to traditional weaning parameters. Methods The observational cohort stu...
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| Format: | Article |
| Language: | English |
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BMC
2023-03-01
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| Series: | BMC Anesthesiology |
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| Online Access: | https://doi.org/10.1186/s12871-023-02039-7 |
| _version_ | 1797863721514565632 |
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| author | Yingying Zheng Zujin Luo Zhixin Cao |
| author_facet | Yingying Zheng Zujin Luo Zhixin Cao |
| author_sort | Yingying Zheng |
| collection | DOAJ |
| description | Abstract Background To evaluate the predictive value of N-terminal prohormone B-type natriuretic peptide (NTproBNP) for weaning failure among patients undergoing major surgeries during spontaneous breathing trial (SBT), compared to traditional weaning parameters. Methods The observational cohort study retrospectively included postsurgical patients who received IMV and underwent a 2 h SBT. According to weaning outcome, NTproBNP level at initiation (NTproBNP1) and at end of 2 h SBT(NTproBNP2), the ΔNTproBNP%, RSBI and MV were compared between weaning failure and weaning success group. Multiple logistical regression and ROC curve were used to evaluate the capability of NTproBNP to predict weaning failure. Results Out of the 323 included postsurgical patients, 45 (13.9%) patients had failed weaning. The ΔNTproBNP% was a better predictor for weaning failure (AUC 0.744;95%CI,0.693–0.791) than NTproBNP1(AUC 0.639; 95%CI,0.580–0.694)), NTproBNP2(AUC 0.742, 95%CI,0.688–0.792) and other traditional weaning index such as RSBI (AUC 0.651; 95%CI, 0.597–0.703) and MV (AUC 0.552; 95%CI,0.496–0.607). The cutoff value of ΔNTproBNP% for predicting weaning failure was 23.3% with the sensitivity75.76% and specificity73.38%. The multiple logistic regression analysis found that ΔNTproBNP%>23.3% was an independent predictor of weaning failure. Conclusion ΔNTproBNP% may be a useful marker for predict weaning failure for postsurgical patients, and it’s better to be more careful to withdraw from invasive mechanical ventilation for those postsurgical patients with ΔNTproBNP% >23.3%. The corresponding interventions to optimize cardiac function should be actively given to these patients. |
| first_indexed | 2024-04-09T22:40:04Z |
| format | Article |
| id | doaj.art-07c5f7c1f81348a7a1398d22e992065f |
| institution | Directory Open Access Journal |
| issn | 1471-2253 |
| language | English |
| last_indexed | 2024-04-09T22:40:04Z |
| publishDate | 2023-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Anesthesiology |
| spelling | doaj.art-07c5f7c1f81348a7a1398d22e992065f2023-03-22T12:12:40ZengBMCBMC Anesthesiology1471-22532023-03-012311910.1186/s12871-023-02039-7NT-proBNP change is useful for predicting weaning failure from invasive mechanical ventilation among postsurgical patients: a retrospective, observational cohort studyYingying Zheng0Zujin Luo1Zhixin Cao2Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical UniversityDepartment of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical UniversityDepartment of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical UniversityAbstract Background To evaluate the predictive value of N-terminal prohormone B-type natriuretic peptide (NTproBNP) for weaning failure among patients undergoing major surgeries during spontaneous breathing trial (SBT), compared to traditional weaning parameters. Methods The observational cohort study retrospectively included postsurgical patients who received IMV and underwent a 2 h SBT. According to weaning outcome, NTproBNP level at initiation (NTproBNP1) and at end of 2 h SBT(NTproBNP2), the ΔNTproBNP%, RSBI and MV were compared between weaning failure and weaning success group. Multiple logistical regression and ROC curve were used to evaluate the capability of NTproBNP to predict weaning failure. Results Out of the 323 included postsurgical patients, 45 (13.9%) patients had failed weaning. The ΔNTproBNP% was a better predictor for weaning failure (AUC 0.744;95%CI,0.693–0.791) than NTproBNP1(AUC 0.639; 95%CI,0.580–0.694)), NTproBNP2(AUC 0.742, 95%CI,0.688–0.792) and other traditional weaning index such as RSBI (AUC 0.651; 95%CI, 0.597–0.703) and MV (AUC 0.552; 95%CI,0.496–0.607). The cutoff value of ΔNTproBNP% for predicting weaning failure was 23.3% with the sensitivity75.76% and specificity73.38%. The multiple logistic regression analysis found that ΔNTproBNP%>23.3% was an independent predictor of weaning failure. Conclusion ΔNTproBNP% may be a useful marker for predict weaning failure for postsurgical patients, and it’s better to be more careful to withdraw from invasive mechanical ventilation for those postsurgical patients with ΔNTproBNP% >23.3%. The corresponding interventions to optimize cardiac function should be actively given to these patients.https://doi.org/10.1186/s12871-023-02039-7Invasive mechanical ventilationWeaning failureCardiovascular dysfunctionNT-proBNPPostsurgical patients |
| spellingShingle | Yingying Zheng Zujin Luo Zhixin Cao NT-proBNP change is useful for predicting weaning failure from invasive mechanical ventilation among postsurgical patients: a retrospective, observational cohort study BMC Anesthesiology Invasive mechanical ventilation Weaning failure Cardiovascular dysfunction NT-proBNP Postsurgical patients |
| title | NT-proBNP change is useful for predicting weaning failure from invasive mechanical ventilation among postsurgical patients: a retrospective, observational cohort study |
| title_full | NT-proBNP change is useful for predicting weaning failure from invasive mechanical ventilation among postsurgical patients: a retrospective, observational cohort study |
| title_fullStr | NT-proBNP change is useful for predicting weaning failure from invasive mechanical ventilation among postsurgical patients: a retrospective, observational cohort study |
| title_full_unstemmed | NT-proBNP change is useful for predicting weaning failure from invasive mechanical ventilation among postsurgical patients: a retrospective, observational cohort study |
| title_short | NT-proBNP change is useful for predicting weaning failure from invasive mechanical ventilation among postsurgical patients: a retrospective, observational cohort study |
| title_sort | nt probnp change is useful for predicting weaning failure from invasive mechanical ventilation among postsurgical patients a retrospective observational cohort study |
| topic | Invasive mechanical ventilation Weaning failure Cardiovascular dysfunction NT-proBNP Postsurgical patients |
| url | https://doi.org/10.1186/s12871-023-02039-7 |
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