Cardiac effects of positive pressure ventilation in ARDS assessed by NT-proBNP, Troponin T and Troponin I

Conclusions In patients with ARDS positive pressure ventilation may adversely affect the heart as reflected by elevations of NT-proBNP. High NT-proBNP level was correlated with high PEEP, low PH and low PaO2/FiO2 ratio while Trop T and Trop I did not show significant correlations with respiratory parameters. None of the cardiac markers NT-proBNP, Troponin I or Troponin T showed any significant correlation with lung mechanics parameters (Cdyn, RaW, Ceff, PIP, Pplat, Pmean, p >0.05) in ARDS patients with structurally normal hearts. Although the increase in cardiac markers are insignificant, yet they point to the potentially harmful role played by high PEEP, low PH and low PaO2/FiO2 ratio on the heart. Currently, no clinically relevant conclusion can be drawn apart from the recommendation to attempt to lower PEEP and shorten the duration of positive pressure ventilation, even in patients with structurally normal hearts.
Source: The Egyptian Journal of Critical Care Medicine - Category: Intensive Care Source Type: research