Help Please

Trauma Columnist · Nov 30, 2004

Okay - I'll bite on this one...what's BNP?? Brain naturetic peptide? Some other acronym?

VickyRN, MSN, DNP, RN · Nov 30, 2004

This is a fairly new OBJECTIVE criteria for congestive heart failure. Basically same as atrial naturietic peptide: hormone released by the right atria of the heart when it is stretched too much--such as occurs in left-sided heart failure and acute oliguric renal failure. BNP > 200 usually signifies congestive heart failure, even if the patient's presenting symptoms do not yet corrorborate (crackles, dyspnea, etc.). So with this simple blood test, one can quickly intervene for CHF before the symptoms get out of hand.

DutchgirlRN, ASN, RN · Nov 30, 2004

BNP > 200 usually signifies congestive heart failure, even if the patient's presenting symptoms do not yet corrorborate (crackles, dyspnea, etc.). So with this simple blood test, one can quickly intervene for CHF before the symptoms get out of hand.

I think "BNP" is the strangest of blood tests yet. I see it ordered alot on the med-surg floor. The results always come back astronomical 3,000-6,000! It's always ordered on CHF patients and then when the results come back through the roof the lab calls hysterical with the panic lab value and the Doc always says "well that's to be expected". I think it needs to be reserved for patients suspected of CHF not in confirmed and chronic CHF, whats the point otherwise?

Another strange test is D-Dimer. It's to r/o P.E.? Supposedly a negative result means no P.E. look no further and a positive means a P.E. is possible but not absolute keep looking. Whether the D-Dimer comes back positive or negative the physician always goes on to rule out a P.E., so why do it in the first place? A P.E. is such a critical diagnosis why not go with a scan or CTA first rather than waiting on the D-Dimer?

CarVsTree · Nov 30, 2004

I know my mother's cardiologist uses BNP for titrating Natrecor. He has had my mother on Natrecor in prep for sx and intermittently to counteract HF exacerbations. It's very expensive stuff.

Also, her cardiologist looks at the whole person, sometimes my mom's numbers are elevated, but she is asymptomatic. In that instance, he has her continue her regular meds without additional Natrecor tx.

le0128 · Dec 1, 2004

yes also called b-type naturetic peptide

Okay - I'll bite on this one...what's BNP?? Brain naturetic peptide? Some other acronym?

Trauma Columnist · Dec 1, 2004

I just wondered if BNP referred to something else. We too use the BNP to titrate Natrecor in the ER. CHF is one of the adult diagnosis that Medicare will reimburse for our emergency care unit and they base it on the use of Natrecor for a few hours and then discharge.