Study of Serum B-Type Natriuretic Peptide (BNP) Levels as a Prognostic Marker in Acute Exacerbation of COPD in HSK Hospital, Bagalkot, Karnataka

Author(s): Sunil Baragi1, Kadappa Jaligidad2, Joachim Piedade Souza3

Pulmonary hypertension (PH) and heart failure are common comorbidities in 20 –
30 % of chronic obstructive pulmonary disease (COPD) patients with acute
exacerbation. Similarities in signs and symptoms and lack of objective measures
to stratify them at emergency department makes the management difficult.
Echocardiography though useful requires specialised training. Hence, B-Type
Natriuretic Peptide (BNP) is a simple test that can prognosticate the severity and
can influence management in such patients. The purpose of the study was to
estimate the significance of BNP during acute exacerbation of chronic obstructive
pulmonary disease (AECOPD) as an important marker of severity and to study its
correlation with duration of hospital stay, place and mode of management in
patients with severe and life-threatening exacerbation of COPD.
This is a prospective longitudinal observational study conducted on 50 patients of
severe and life-threatening COPD exacerbation admitted to General Medicine
department of HSK hospital, Bagalkot and their outcomes were noted based on
the BNP levels.
The study showed higher levels of BNP in patients admitted to ICU as compared
to emergency ward (P = 0.001). Greater values among those on invasive
mechanical ventilation vs. non-invasive ventilation (NIV). There was a positive
correlation and statistical significance of BNP values with arterial blood gases
(ABG) parameters like pulmonary hypertension (PH), partial pressure of carbondi-
oxide (PaCO2), partial pressure of oxygen (PaO2), echo parameters like right
ventricle (RV) diameter and pulmonary artery systolic pressure (PASP) and
duration of hospital stay.
BNP is a simple, low cost and easily available blood test that can prognosticate
oxygen requirement, mode of ventilation, place of management and can grade
and reflect the severity in acute exacerbation of COPD.