Sindhvananda W, Bunpeth C, Chareonkulnawanun N (2019) N-Terminal Pro-Brain Natriuretic Peptide in Post Cardiac Surgery as a Predictor of Ventilator-Weaning Outcomes. Int J Anesthetic Anesthesiol 6:085.


© 2019 Sindhvananda W, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

ORIGINAL ARTICLE | OPEN ACCESS DOI: 10.23937/2377-4630/1410085

N-Terminal Pro-Brain Natriuretic Peptide in Post Cardiac Surgery as a Predictor of Ventilator-Weaning Outcomes

Wacharin Sindhvananda, MD, MPH, PhD1,2*, Chonlada Bunpeth, MD2 and Nuthathai Chareonkulnawanun3

1Department of Anesthesiology, Chulalongkorn University, Bangkok, Thailand

2Cardiovascular Thoracic and Intensive Care Centre, Chulalongkorn Hospital, Thailand

3Division of Anesthesiology, Bhumibol Adulyadej Hospital, Thailand



An increase of NT-proBNP has been proved to be a predictor for ventilator weaning failure in several medical conditions. However, relation between NT-proBNP and ventilator-weaning outcomes after cardiac surgery has not yet been elucidated. This study was to investigate relationship between blood NT-proBNP and ventilator-weaning outcomes.


A prospective analytical study was at Cardiovascular-thoracic intensive care unit. Cardiac-surgery patients (age 18-80 Y, consented and without exclusion criteria) were included. Blood NT-proBNP was sampling at pre-operation time and at weaning. Early-weaning outcomes were categorized into simple, difficult, and prolong weaning. Late-weaning outcomes were reintubation and suspicious cardiopulmonary compensations. Blood NT-proBNPs were compared among/between early and late-weaning outcomes. Area under the curve and sensitivity/specificity at various cut-off values for poor weaning outcomes were analyzed.


A final of 134 patients were analyzed. The mean NT-proBNPs (pre-operation and weaning) were 1,417.8 and 4,532.5 pg/ml, respectively. wide variations of NT-proBNPs were observed. NT-proBNPs were not significantly related to difficult, prolong, and reintubation; but significantly related to suspicious cardiopulmonary compensations. AUC range were 0.43-0.65.


NT-proBNP increased 4-5-fold after cardiac surgery. A significant increase was related to sympathetic activation, not weaning-induced LV load. Due to low sensitivity, NT-proBNPs were not good predictors for difficult or prolong weaning and reintubation in post cardiac surgery.