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Updated: Jun 27, 2026

A Structured Approach to Extubation in Mechanically Ventilated Rats
Published on: July 18, 2025
Behavior of B-type natriuretic peptide during mechanical ventilation and spontaneous breathing after extubation
T Principi1, G Falzetti, D Elisei
1Azienda Ospedaliero-Universitaria Ospedali Riuniti Umberto I, G. M. Lancisi, G. Salesi, Ancona, Italy.
Background:
The behavior of B-type natriuretic peptide (BNP) is assessed during mechanical ventilation (MV) and spontaneous breathing after extubation in critical patients.
Methods:
Thirty patients admitted in the Intensive Care Unit (ICU) were enrolled. BNP, fluid balance (FB), airway pressure (AP) and dobutamine infusion needing (DP) were registered in three stages: T0, admission to ICU; T1, before extubation; T2, 24 h after extubation.
Results:
Patients with congestive heart failure (CHF) had BNP values higher than other patients. The value of BNP during MV was greater than normal in all patients. The cut-off to discriminate patients with heart failure during MV was 286 pgxmL(-1)(sensitivity: 86%; specificity: 90%). The increase of BNP during MV directly correlated with FB and inversely correlated with AP and DP. The plasmatic level of BNP remained higher than normal values 24 h after extubation.
Conclusions:
The underlying disease of an ICU patient seems to play a relevant role for BNP production and is probably linked to different aspects of therapeutic approach required by the patient. Our data suggest a cut-off value of BNP higher than the usual is necessary to discriminate mechanically-ventilated patients without CHF. This study should be repeated with an enlarged population.
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