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[BNP measurement for perioperative management]
Toshihiko Ishiguro1, Yasuaki Gyouda, Akitaka Yoshizawa
1Department of Anesthesiology and Internal Medicine, Kanamecho Hospital, Tokyo 171-0063.
Masui. the Japanese Journal of Anesthesiology
|May 26, 2009
Summary
B type natriuretic peptide (BNP) measurement can screen for asymptomatic chronic heart failure in surgical patients. Preoperative BNP levels do not predict perioperative cardiac events but are elevated in elderly patients and those with cardiac conditions.
Area of Science:
- Cardiology
- Biomarkers
- Anesthesiology
Context:
- Evaluating anesthesia tolerance in patients with congestive heart failure risk factors is challenging.
- B type natriuretic peptide (BNP) is a known biomarker for left ventricular (LV) dysfunction.
- This study investigated BNP's utility in perioperative management for gastro-intestinal cancer patients.
Purpose:
- To assess the role of preoperative BNP measurements in predicting perioperative circulatory characteristics and cardiac events.
- To determine if BNP can identify patients with asymptomatic chronic heart failure due to LV diastolic dysfunction.
Summary:
- 101 gastro-intestinal cancer patients undergoing intraperitoneal surgery had plasma BNP measured preoperatively and some postoperatively.
- Preoperative BNP was higher in elderly patients and those with cardiac complications, but did not correlate with perioperative circulatory status or cardiac events.
- BNP measurement is useful for screening asymptomatic chronic heart failure, likely due to LV diastolic dysfunction, rather than predicting perioperative events.
Impact:
- BNP serves as a valuable screening tool for identifying patients with underlying, asymptomatic chronic heart failure.
- The findings aid in optimizing perioperative management strategies for high-risk surgical patients.
- Highlights the potential of BNP in diagnosing LV diastolic dysfunction in a surgical cohort.
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