Evaluation of serum proB-Type natriuretic peptide in prospecting extubation failure in thoracoabdominal surgical patients in intensive care unit

Abstract

Extubation is a critical moment in the ICU stay. Despite meeting all weaning criteria and succeeding in a weaning trial, failure of planned extubation occurs in about 10–20% of cases and patients have a high mortality. Many studies reported higher failure rates and has not yet been detected reliably predict of weaning. Studies in the field of weaning B-type natriuretic peptide (BNP) and NT-proBNP levels have been suggested as useful indicators of weaning failure. Meanwhile proBNP is more stable, has a longer half-life, and may be a better biomarker to determine the outcomes of critically ill patients and the ventilator weaning. So, because there is still no theoretical certainty about the ideal time and methods of weaning. On the other hand, there is a need for a comprehensive review of the role of proBNP in the ICU. Therefore, the present study evaluated proBNP plasma levels and Prognosis in patients undergoing thoracoabdominal surgeries. Method: Patients who were transferred to the ICU ward after thoracoabdominal surgeries were enrolled. sampling for natriuretic peptides were performed at the early hours of intensive care unit admission and 24 hours later. Demographic data, hemodynamic and respiratory parameters, length of stay in ICU, APACHE II scores and mortality rate were recorded and Data were analyzed using t-test, Mann-Whitney and Chi-square tests. Results: Of the 150 patients studied, 133 patients had successful extubation and 12 patients failed the weaning trial and required re-intubation. In the weaning failure groups, higher levels of proBNP were observed compared to patients with successful weaning trial. Also, instability in hemodynamic parameters was observed in weaning failure groups.