Critically ill patients and circulating amino-terminal pro-c-type natriuretic peptide

Alexander Koch, Frank Tacke

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review

Abstract

The natriuretic peptide family members, atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), and C-type natriuretic peptide (CNP), exert multiple potent diuretic, natriuretic, and vasorelaxant functions, thereby directly influencing body-fluid homeostasis and blood pressure control. C-type natriuretic peptide (CNP) is mainly synthesized in the vasculature. We have evaluated the diagnostic and prognostic value of N-terminal proCNP (NT-proCNP) in 273 critically ill patients (197 patients with sepsis or septic shock, 76 without evidence of sepsis) in comparison to 43 healthy controls. Critically ill patients displayed significantly elevated NT-proCNP serum concentrations upon admission to the ICU compared to healthy controls, especially in conditions of sepsis. NT-proCNP correlated with inflammatory parameters (i.e., C-reactive protein, procalcitonin, and TNF-α), biomarkers of organ dysfunction, and clinical composite scores (APACHE II, SOFA, SAPS2). Despite its potential involvement in the pathogenesis of critical illness and sepsis, NT-proCNP may also be valuable as a prognostic biomarker in the ICU setting, because NT-proCNP levels at admission and day 3 were found to be predictive for ICU and overall survival. Further studies are warranted to elucidate the underlying pathomechanisms of NT-proCNP in critical illness and to validate its potential as a biomarker at the ICU.

Original languageEnglish
Title of host publicationDiet and Nutrition in Critical Care
PublisherSpringer New York
Pages143-151
Number of pages9
ISBN (Electronic)9781461478362
ISBN (Print)9781461478379
DOIs
StatePublished - 1 Jan 2015
Externally publishedYes

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