N-Terminal Pro-B-Type Natriuretic Peptide, C-Reactive Protein and Albumin as Prognostic Markers in Severe Sepsis and Septic Shock

Introduction: There is growing evidence supports the hypothesis that BNP could be an early predictor of mortality in septic shock.Aim of the Work: Study the relationship between amino-terminal pro-BNP levels and the severity of organ dysfunction and mortality on admission in severe sepsis and septic shock and correlate its level with CRP and albumin.Patients and Methods: This study population consisted of fifty patients aged 18 years, who were admitted to critical care department. Eligible patients were enrolled within 24 hours of admission to the ICU with severe sepsis and/or septic shock. Laboratory work up specific for our study (on ICU admission) was BNP through collected heparinated blood sample, CRP and albumin. Also all laboratory study and clinical assessment needed to calculate APACHE II and SOFA score were done beside imaging investigations (if needed).Results: The patients were divided to 2 groups according to the mortality outcome, Group I (survivors, 31 patients) and Group II (non survivors, 19 patients) there was higher level of NT proBNP in Group II (4619.6±2118. 1pg/ml) compared to Group I (2328.2±206 1.0pg/ml) with a statistically significant p-value ( 0.001). There were significant strong positive correlation between serum NT proBNP levels with serum CRP levels (r.–0.28 and p.0.05) there were significant strong positive correlations between serum NTproBNP levels with both APACHEII score (r.0.74 and p. 0.001) and SOFA score (r.0.62 and p.0.00).Conclusion: BNP levels in patients with severe sepsis and septic shock have a beneficial rule in (ICU) for high risk stratification of critically ill patients, as it is an independent prognostic marker of mortality in severe sepsis.