Effects of high-urgency ambulance transportation on pro-B-type natriuretic peptide levels in patients with heart failure

Weber, Ulrike; Reitinger, Agnes; Erdeii, Tomasz; Hellmich, Christian; Steinlechner, Barbara; Hager, Helmut; Selzer, Michael; Hiesmayr, Michael; Rajek, Angela; Kober, Alexander

doi:10.1016/j.ajem.2008.12.041

« Previous Next »American Journal of Emergency Medicine
Volume 28, Issue 5 , Pages 568-576, June 2010

Effects of high-urgency ambulance transportation on pro-B-type natriuretic peptide levels in patients with heart failure☆

Ulrike Weber, MD
- Department of Anesthesiology, General Intensive Care and Pain Control, Medical University of Vienna, A-1090 Vienna, Austria
- Corresponding author. Tel.: +43 1 40400 4109; fax: +43 1 40400 4110.
Agnes Reitinger, MD
- Department of Anesthesiology, General Intensive Care and Pain Control, Medical University of Vienna, A-1090 Vienna, Austria
Tomasz Erdeii, MD
- Department of Analytical Medicine and Biochemistry, Medical “Semmelweis” University of Budapest, 1094 Budapest, Hungary
Christian Hellmich
- Vienna Red Cross Ambulance Service, Vienna, 1030 Austria
Barbara Steinlechner, MD
- Department of Anesthesiology, General Intensive Care and Pain Control, Medical University of Vienna, A-1090 Vienna, Austria
Helmut Hager, MD
- Department of Anesthesiology, General Intensive Care and Pain Control, Medical University of Vienna, A-1090 Vienna, Austria
Michael Selzer, MD
- Department of Anesthesiology, General Intensive Care and Pain Control, Medical University of Vienna, A-1090 Vienna, Austria
Michael Hiesmayr, MD
- Department of Anesthesiology, General Intensive Care and Pain Control, Medical University of Vienna, A-1090 Vienna, Austria
Angela Rajek, MD
- Department of Anesthesiology, General Intensive Care and Pain Control, Medical University of Vienna, A-1090 Vienna, Austria
Alexander Kober, MD
- Department of Anesthesiology, General Intensive Care and Pain Control, Medical University of Vienna, A-1090 Vienna, Austria

Received 23 November 2007; received in revised form 17 December 2008; accepted 19 December 2008. published online 30 November 2009.

Abstract

Objectives

We hypothesized that pro-B-type natriuretic peptide (proBNP) levels in venous blood increase in patients with acute out-of-hospital heart failure because of stress during emergency ambulance transportation, and furthermore, we wanted to show if there is an effect of increasing proBNP levels on hemodynamic parameters.

Methods

Venous proBNP levels, visual analog scale (VAS) for pain and anxiety before and after transportation, heart rate, blood pressure, and transcutaneous Spo₂ were measured every 3 minutes in 32 patients with defined clinical signs of heart failure.

Results

ProBNP levels increased significantly (P < .01) during transportation (278.13 ± 113.20 vs 984.67 ± 627.33 pg/mL), whereas heart rate and mean blood pressure remained almost stable. There was no significant change in VAS for pain and anxiety (3.79 ± 3.70 and 2.89 ± 3.01 vs 2.13 ± 3.30 and 1.57 ± 2.78).

Conclusion

A rapid increase in proBNP levels was shown in patients with acute out-of-hospital heart failure during emergency ambulance transportation but no significant changes in hemodynamic parameters.