Usefulness of B-type natriuretic peptide in elderly patients with acute dyspnea

• Published in: Intensive care medicine 2004-12, Vol.30 (12), p.2230-2236
• Main Authors: RAY, Patrick, ARTHAUD, Martine, LEFORT, Yannick, BIROLLEAU, Sophie, BEIGELMAN, Catherine, RIOU, Bruno
• Format: Article
• Language: English
• Subjects: Acute Disease; Aged; Aged, 80 and over; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood Gas Analysis; Cardiology. Vascular system; Clinical death. Palliative care. Organ gift and preservation; Coronary heart disease; Dyspnea - blood; Dyspnea - diagnosis; Dyspnea - etiology; Emergency Service, Hospital; Female; Heart; Humans; Intensive care medicine; Male; Medical sciences; Natriuretic Agents - blood; Natriuretic Peptide, Brain - blood; Prospective Studies; Pulmonary Edema - complications; Pulmonary Edema - diagnosis; Respiration; ROC Curve; Sensitivity and Specificity
• ISSN: 0342-4642; 1432-1238
• DOI: 10.1007/s00134-004-2469-0

Differentiating cardiogenic pulmonary edema (CPE) from respiratory causes of dyspnea is particularly difficult in elderly patients. The aim of our study was to evaluate B-type natriuretic peptide (BNP) in patients older than 65 years presenting with acute dyspnea. Prospective study. Medical emergency department of a 2000-bed urban teaching hospital. Patients aged over 65 years presenting with acute dyspnea and a respiratory rate more than 25/min or a PaO(2) below 70 mmHg, SpO(2 )less than 92%, PaCO(2) higher than 45 mmHg with pH less than 7.35, were included. BNP levels, measured blind at admission were compared with the final diagnosis (CPE or no CPE) as defined by experts. None. Three hundred eight patients (mean age of 80 years) were enrolled in the study. The median BNP was 575 pg/ml [95% confidence interval (CI): 410-898] in the CPE group (n=141) versus 75 pg/ml (95% CI: 59-98) in the no CPE group (n=167) (p