Alveolar recruitment strategy improves arterial oxygenation after cardiopulmonary bypass.docVIP

Available online /supplements/5/S4 Selected abstracts from presentations to the 18th Autumn Meeting of the Association of Cardiothoracic Anaesthetists 16 November 2001, London, UK Association of Cardiothoracic Anaesthetists The publication of these abstracts was made possible by an unrestricted educational grant from Bayer plc Published online: 7 November 2001 Critical Care 2001, 5 (Suppl 4):1-8 ? 2001 BioMed Central Ltd (Print ISSN 1364-8535; Online ISSN 1466-609X) 1 Serum N-terminal pro brain natriuretic peptide (NTproBNP) in perioperative cardiac surgical patients A Crerar-Gilbert, A Dewhurst, SC Barnes, PO Collinson and GR McAnulty Anaesthetic Department and Department of Clinical Biochemistry, St Georges Hospital, London, UK Introduction: Brain natriuretic peptide (BNP) is released from stretched ventricular wall. BNP particularly the N-terminal portion of proBNP (NTproBNP) is a sensitive marker of congestive heart failure and predictor of outcome [1]. Variations in NTproBNP in cardiac surgical patients are not well described [2]. We investi- gated changes in NTproBNP in relation to clinical progress in open heart surgery patients. Figure 1 25,000 20,000 15,000 10,000 5,000 0 Died Prolonged stay Uncomplicated Methods: We measured serum concentrations of NTproBNP in 15 perioperative cardiac surgical patients in a pilot observational study using an electrochemiluminescent sandwich immunoassay (Elecsys 2010, Roche Diagnostics: interassay c.v. 5.0% at 380ng/l, 4.4% at 8700ng/l, 5.0% at 13000ng/l, detection limit 20ng/l, upper measuring limit 25,000ng/l). We collected samples on induction of anaesthesia, at the end of the surgery, 12hourly for 3 days, then daily for 3 days. 0 1 2 3 4 5 6 7 8 Time (days) NTproBNP concentrations in 15 heart surgery patients. Results: Two patients of 15 died. One had preoperative right ven- tricular failure and a baseline NTproBNP of 25,000ng/l falling to 18613ng/l p