INCREASED PLASMA-CONCENTRATIONS OF BRAIN NATRIURETIC PEPTIDE IN PATIENTS WITH ACUTE LUNG INJURY

Purpose: This study was performed to elucidate the pathophysiological role of brain natriuretic peptide (BNP) and atrial natriuretic peptide (ANP) in acute lung injury. Materials and Methods: We sequentially me asured plasma concentrations of immunoreactive BNP and ANP in 10 patie nts (mean age, 63 years) with acute lung injury and compared those wit h hemodynamic parameters and pulmonary functions. Results: Plasma conc entrations of immunoreactive BNP and ANP were markedly elevated at ent ry into the study. Plasma BNP concentrations during the early course ( 3 days) showed significant (P < .01) positive correlations with system ic vascular resistance index (r = .708) and pulmonary vascular resista nce index (r = .573), but a negative correlation with cardiac index (r = -.608), Plasma ANP concentrations showed a significant (P < .05) po sitive correlation with pulmonary capillary wedge pressure (r = .398), Plasma BNP in 4 patients who died and 1 patient with acute renal fail ure remained elevated during the entire hospital length of stay (12 da ys), Conclusion: These findings suggest that circulating BNP plays an important role in acute lung injury along with ANP as a compensatory m echanism for cardiac dysfunction accompanied by increased systemic vas cular resistance index and pulmonary vascular resistance index, Circul ating BNP may be a sensitive humoral marker for the degree of ventricu lar dysfunction associated with acute lung injury. Copyright (C) 1997 by W.B. Saunders Company.