tailieunhanh - Báo cáo y học: " Diagnostic utility of C-reactive Protein combined with brain natriuretic peptide in acute pulmonary edema: a cross sectional study"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học 'Respiratory Research cung cấp cho các bạn kiến thức về ngành y đề tài: " Diagnostic utility of C-reactive Protein combined with brain natriuretic peptide in acute pulmonary edema: a cross sectional study. | Komiya et al. Respiratory Research 2011 12 83 http content 12 1 83 RESPIRATORY RESEARCH RESEARCH Open Access Diagnostic utility of C-reactive Protein combined with brain natriuretic peptide in acute pulmonary edema a cross sectional study 1 r- s 1 1 I l z- .v-v- i - 1 I_I I r I I íí 1C I I I I 2 r KỲ I I I 1 - r I 3 I f I I r I Ỉ c r I m 4 I I W z t I i hi5 KosaKu Komiya Hiroshi Ishii Shinji leramoto osamu laKahashi noduoki Eshima ou Yamaguchi Noriyuki Ebi5 Junji Murakami6 HidehiKo Yamamoto5 and Jun-ichi Kadota1 Abstract Introduction Discriminating acute lung injury ALI or acute respiratory distress syndrome ARDS from cardiogenic pulmonary edema CPE using the plasma level of brain natriuretic peptide BNP alone remains controversial. The aim of this study was to determine the diagnostic utility of combination measurements of BNP and C-reactive protein CRP in critically ill patients with pulmonary edema. Methods This was a cross-sectional study. BNP and CRP data from 147 patients who presented to the emergency department due to acute respiratory failure with bilateral pulmonary infiltrates were analyzed. Results There were 53 patients with ALI ARDS 71 with CPE and 23 with mixed edema. Median BNP and CRP levels were 202 interquartile range 95-439 pg mL and 119 62-165 mg L in ALI ARDS and 691 416-1 194 pg mL p and 8 2-42 mg L p in CPE. BNP or CRP alone offered good discriminatory performance C-statistics and but the combination offered greater one C-statistics p versus BNP p versus CRP . In multiple logistic-regression BNP and CRP were independent predictors for the diagnosis after adjusting for other variables. Conclusions Measurement of CRP is useful as well as that of BNP for distinguishing ALI ARDS from CPE. Furthermore a combination of BNP and CRP can provide higher accuracy for the diagnosis. Introduction Acute hypoxic respiratory failure due to pulmonary edema is a common reason for visiting the