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B-type natriuretic peptide (BNP) currently is being used primarily to distinguish between cardiac and noncardiac causes of dyspnea in acute care settings. Now, researchers in Boston have assessed BNP's value in distinguishing between cardiogenic and noncardiogenic shock in the intensive care unit. Their premise was that BNP levels might correlate positively with cardiac filling pressures.
The subjects were 49 consecutive ICU patients with shock for whom clinicians were about to place pulmonary artery catheters for diagnosis or monitoring. Blood concentrations of BNP, measured at the time of catheter placement, ranged from <5 pg/mL to >5000 pg/mL (mean, 1133 pg/mL). BNP level did not correlate with either pulmonary capillary wedge pressure or…