The relationship of preoperative N-terminal pro-BNP and the amount of hemodynamic drugs used during noncardiac surgery

ABSTRACT

BACKGROUND: BNP and NT-proBNP are very useful predictor of perioperative cardiac events. The authors therefore performed a retrospective study about the relationship between NT-proBNP and intraoperative hemodynamic stability. METHODS: The authors reviewed the chart of 126 patients which were consulted to cardiologists for preoperative cardiac evaluation from 2005 through 2007. All patients were divided into two groups; N-group (NT-proBNP or = 300 pg/ml, n = 60). The kinds of hemodynamic drugs and dosage and infusion time were calculated. Total amounts of hemodynamic drugs are scored by two methods. Infusion drugs were scored 30 points, bolus drugs (esmolol 30 mg, labetalol 10 mg, phenylephrine 50microg, ephedrine 10 mg, atropine 0.25 mg, nicardipine 0.5 mg) and preclusive nitroglycerin infusion were scored 5 points. Drug score is total sum of all scores. We compared the drug score of two groups. In addition, bivariate and partial correlation analysis were performed for the correlation of drug score. RESULTS: H-group showed a high (P = 0.029) drug score (17.68 +/- 21.78) more than N-group (10.13 +/- 15.79). H-group showed a low (P = 0.000) ejection fraction (51.69 +/- 12.90%) more than N-group (61.80 +/- 7.84%). But, only age (R: 0.234, P: 0.023) and ejection fraction (R: -0.222, P: 0.032) were correlated with drug score by partial correlation analysis. CONCLUSIONS: Patients with preoperative high NT-proBNP had decreased systolic function and demanded more hemodynamic drugs during noncardiac surgery. But, NT-proBNP was not correlated with drug score in itself.