Roles of small-dose recombinant human brain natriuretic peptide without bolus in Chinese older patients with septic cardiac dysfunction.

PURPOSE

Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. As one of the most common organs is affected by sepsis, cardiac dysfunction increases adverse prognosis. This study was designed to analyze the roles of small-dose recombinant human brain natriuretic peptide without bolus in Chinese older patients with septic cardiac dysfunction.

METHODS

This study recruited 250 Chinese older patients with sepsis cardiac dysfunction in intensive care unit. Participants were randomly allocated into the control group (n = 125) and recombinant human brain natriuretic peptide group (n = 125). The control group received early goal-directed therapy, and the recombinant human brain natriuretic peptide group received recombinant human brain natriuretic peptide therapy in addition to early goal-directed therapy.

RESULTS

There was no significant difference in medical histories, infection types, failing organs, mortality within 28 days [37 (29.6%) vs. 34 (27.2%)], intensive care unit stay [27 (21.6) vs. 22 (17.6)] and hospital stay [41 (32.8%) vs. 37 (29.6%)] between the control and recombinant human brain natriuretic peptide groups (P > 0.05 for all). Lengths of intensive care unit [16 (13-22) days] and hospital stay [25 (22-30) days] in the recombinant human brain natriuretic peptide group were significantly shorter than in the control group [21 (14-23) days; 27 (23-30) days; P < 0.05 for all]. There was no significant difference in mean daily Sequential Organ Failure Assessment score between the two groups (P > 0.05 for all). Cardiovascular and respiratory scores (P < 0.05 for all) but not other organ scores (P > 0.05 for all) were significantly lower in the recombinant human brain natriuretic peptide group than in the control group.

CONCLUSIONS

Small-dose recombinant human brain natriuretic peptide was unable to lower the mortality and improve the liver, renal, and coagulation functions, but able to shorten the length of hospital stay and improve the cardiovascular and respiratory functions in Chinese older patients with septic cardiac dysfunction.