Abstract
B TYPE NATRIURETIC PEPTIDE AS A PREDICTOR OF OUTCOME IN ACUTE EXACERBATION OF CHRONIC OBSTRUCTIVE PULMONARY DISEASES

*Devendra Pratap Yadav, Govind Narayan Srivastava and Puja Yadav

ABSTRACT

Chronic obstructive pulmonary disease (COPD) is a preventable and treatable disease associated with significant morbidity and mortality. Exacerbation is defined as acute worsening of respiratory symptoms that results in additional therapy. Exacerbation accelerate the rate of decline of lung function and associated with significant morbidity and mortality. Aim To analyze the relationship of Serum B type Natriuretic Peptide (BNP) as predictor of outcome in terms of in hospital mortality, need of intervention during hospital stay and post hospital supportive care in patients admitted with Acute Exacerbation of COPD. Method 50 patients with acute exacerbation of COPD above 45 years with no previous history of any independent systemic co-morbidities were recruited for study. Thorough history taking, clinical examination and all relevant investigations were performed. All the patients were treated with standard protocol including oxygen support, nebulisation, systemic antibiotics and corticosteroid . Non-invasive Ventilation and Invasive ventilation support were given whenever required. All the collected data was analysed by SPSS version 16. Result Out of 50 patients recruited 9 patients(18%) did not survive. BNP levels were increased in non-survived group when compared with survived group(mean value 1218 vs 318, p value 0.01). It was statistically significant. Mean BNP was higher in patients who required Mechanical Ventillation support in comparison to patients who needed Non Invasive Ventilation support or no intervention(mean value 480 vs 391 vs 115). BNP was also raised in patients who required domiciliary Long Term Oxygen Therapy. Conclusion BNP acts as predictors of in hospital mortality. It is positively correlated with, intervention required during hospital stay, need of post hospital supportive measures like domiciliary long term oxygen therapy.

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