Anest. intenziv. Med. 2010;21(3):141-145

N-terminal pro-Brain natriuretic peptide (NT-proBNP) in acute brain disease: Elevated serum levels without sodium imbalanceIntensive Care Medicine - Original Paper

Špatenková Věra^1,*, Kazda Antonín², Suchomel Petr¹

¹ Neurocentrum, Krajská nemocnice, Liberec

² Ústavu klinické biochemie a laboratorní diagnostiky Všeobecné fakultní nemocnice a 1. lékařské fakulty Univerzity Karlovy, Praha

Objective:
B-type natriuretic peptide is a member of the peptide family which increases urine and sodium output in the kidneys and causes vasodilatation in the vessels. In acute brain disease it is connected with hyponatraemia and natriuresis, forming the cerebral salt wasting syndrome (CSWS). The aim of this study was to evaluate serum NT-proBNP and its relationship to sodium and water metabolism parameters in patients with acute brain disease in the absence of CSWS.

Design:
Retrospective study.
Setting:
Neurological-neurosurgical intensive care unit, Regional Hospital.
Material and method:
We observed NT-proBNP values in 18 patients (9 women, 9 men, mean Glasgow Coma Scale 14 ± 1) with acute brain disease (subarachnoid haemorrhage 9, intracerebral haemorrhage 2, tumour 5, other 2) with normal renal parameters and New York Heart Association (NYHA) classification I. Serum sodium concentration and osmolality were measured on the day of taking the NT-proBNP sample (day 1) and 24 hours later (day 2), further parameters - urine output, urinary loss of sodium, fluid and sodium intake, were observed for a period of 24 hours after the NT-proBNP measurement.

Results:
Serum levels of NT- proBNP (mean 37.4 ± 29.5 pmol/l, 316.8 ± 250.3 pg/ml) were statistically significantly higher than the normal value (14.8 pmol/l, 125 pg/ml, p = 0.005), while no significant changes were observed in the levels between day 1 and 2 of either serum sodium (p = 0.799) or serum osmolality (p = 0.388). Furthermore, there was no proven significant correlation between NT-proBNP and the measured parameters.

Conclusion:
This study showed a significant elevation of NT-proBNP in patients with acute brain disease that was not accompanied by the development of CSWS.

Keywords: B-type natriuretic peptide; NT-proBNP; hyponatraemia; cerebral salt wasting syndrome

Published: June 1, 2010  Show citation