Prognostic Value of NT-pro BNP in Extracorporeal Membrane Oxygenation Assisted Cardiogenic Shock Patients: A 5-Year Single-Center Retrospective Analysis

Abstract

Abstract Objective This study aimed to evaluate the predictive value of N-terminal pro-brain natriuretic peptide (NT-pro BNP) for venoarterial extracorporeal membrane oxygenation (VA-ECMO)-assisted clinical outcomes in adult patients with cardiogenic shock (CS). Methods: Seventy-seven CS patients who underwent VA-ECMO-assisted therapy at our center between January 2016 and January 2021 were included, and their demographic information and clinical data were collected. The prognostic value of NT-pro BNP in these patients was assessed. Results: Among the study participants, the highest NT-pro BNP values after VA-ECMO assistance were observed in CS patients who had died versus those undergoing rehabilitation (21,439.62 vs. 13,568.26 pg/mL). Mean NT-pro BNP values at the time of ECMO weaning (18,170.95 vs. 8472.8 pg/mL) and before discharge (22,183.35 vs. 5646.197 pg/mL) were higher in the death group. Age; Sepsis-related Organ Failure Assessment scores; creatinine, platelet, blood urea nitrogen, total bilirubin, and lactic acid levels; mean arterial pressure; creatinine level at the time of ECMO weaning; NT-pro BNP value before discharge; and left ventricular ejection fraction percentage were reliable predictors of mortality. The area under the receiver operating characteristic curve (AUC) was >0.70 (P<0.05). The AUC of pre-discharge NT-pro BNP was 0.873, and these NT-pro BNP values had the best predictive ability regarding patient death. Conclusion:Among CS patients who received VA-ECMO assistance, NT-pro BNP values at each assistance point had important patient-related diagnostic and predictive values. Pre-discharge NT-pro BNP values were the best predictors of patient prognosis.