Natrecor and BNP's

Depending on which machine you are running the BNP on, it may take 2 hrs or 24hrs for the Natrecor to "wash.

The patient should not be tested for BNP immediately after taking Natrecor. You are getting elevated levels and are inaccurate.

BNP has to run through the renal system and depending on the pt's age, that system may not be that good.

If the pt's is 75 the cutoff is 450pg/mL. The problem is if you have a 75 tr old pt's that is at 250 and "at risk" and the next day they turn 76. Now they are fine.

We've been using 'Natrecor' more and more as of late for our CHF patients.

Also, we routinely run BNP levels (BTNP) to watch where the pt's heart failure 'stands' and if he's responding to treatment.

Natrecor is 'synthetic' BNP.

We have one cardiologists who orders BNP's despite the fact that his pt's on Natrecor (usually resulting in levels >1300)

Another cardiologist doesn't run BNPs when his Pt's on natrecor...d/t the inevitable >1300 result.

What are your experiences with this?

Is the first cardiologist looking at 'relative' drops, perhaps????

(And yes, he is well aware of natrecor being BNP....i've asked him about it... i jsut didn't have the 'heart' (no pun intended) to tell him the other doc doesn't do so and thinks it's a waste of time....and they're both excellent Doc's...)

If you want to know you need to ask him.I too would be interested in the answer because I can't detemine what your cardiologist expects to learn form a bnp on a pt on natrecor because it is always going to be elevated. A better way to determine the effectiveness of the treatment would be a daily weight.

We have been using the natrecor with pretty good results recently. If the patient is admitted with chf, there is usually a bnp ordered...however, our bnp results are not immediate test results, they usually take a day or so to come back...the docs start them on the medication if clinically indicated..i don't remember them doing follow-up bnp levels but I will ask around...I don't think that they do them during the hospital stay though (unless they follow up in their office after discharge...which I do know that they do in the home care program...)

i think the concensus is that drawing bnp's while a pt's on natrecor is basically useless as it will invariably miff the results. (that doc i've mentioned has ceased his bad behavior...hmmmmm :) .

We're fortunate in that we can have a BNP back in ~15 minutes (if ordered stat). It's a great tool!