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Colegio de Medicina Interna de México.

2020, Number 6

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Med Int Mex 2020; 36 (6)

Variability of brain natriuretic peptide during spontaneous respiratory test as predictor in mechanical ventilation weaning

Ángeles-Márquez M, Huerta-Ramírez S, Cerda-Téllez F, Benítez-Maldonado DR, Rivera-Rangel RM, García-Minamy JI, Torres-Lugo MI, Guillén-González R

Language: Spanish
References: 19
Page: 766-773
PDF size: 217.80 Kb.


ABSTRACT

Background: The identification of the appropriate moment to extubate a patient is of great importance, reintubation is a factor of poor prognosis in patients with mechanical ventilation.
Objective: To evaluate the association between brain natriuretic peptide (BNP) variability and weaning failure.
Material and Method: An observational, cross-sectional analytical and prospective study was conducted in SSA CDMX hospitals. Patients were included in the extubation protocol to whom serum BNP was determined prior to the spontaneous breathing test and 30 minutes after the start of this, the difference and behavior between both intakes were documented; later its evolution was monitored.
Results: We studied 21 patients, mean age was 60 years, the main reason for intubation was neurological deterioration. More failure was found (25%) in those subjects with a decrease in BNP with statistical significance (p = 0.05). The variables BNP1 and BNP2 were associated in a negative way (OR 0.95 and 0.89) to the outcome of failure (p = 0.04 and p = 0.006).
Conclusions: Measurements of BNP variability, during the spontaneous breathing test, specifically in those with a decrease, could be useful in predicting the failure of extubation.


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