[Brain-natriuretic-peptide (BNP) for improvement of the diagnostic determination in a conserving emergency room]

Dyspnea is one of the most common symptoms for presentation in an emergency department. Evaluation of this very unspecific symptom can be very time-consuming and costly. Thus, we investigated the value of a rapid bedside-test for BNP in discriminating dyspnea due to "cardiac" reasons from "non-cardiac" dyspnea in the emergency room.

We studied 100 patients who presented to the emergency department with "severe dyspnoea" as the leading symptom. In all patients BNP was determined from blood samples drawn on admission. All patients had to complete a dyspnea score for severity of dyspnea. The treating physician was blinded to the results of BNP measurements. After discharge patients were divided into "cardiac" and "non-cardiac" dyspnea on the basis of all findings gathered during the hospital stay by a panel of 3 physicians blinded to the results of BNP measurements. The 2 groups were compared for difference in BNP levels and for differences in the dyspnea score. While the dyspnea score showed no significant difference, there was a significant difference in BNP measurements (p < 0.0001).

With the TRIAGE BNP test a rapid discrimination between dyspnea due to ventricular failure and "non-cardiac" dyspnea can be obtained within 20 minutes after first presentation. This test can save time and resources in this critical group of patients.