A comparison of intraoperative goal-directed intravenous administration of crystalloid versus colloid solutions on the postoperative maximum N-terminal pro brain natriuretic peptide in patients undergoing moderate- to high-risk noncardiac surgery

What Was Tested

The paper reports a study of BNP (Nesiritide), published as a randomized controlled trial.

However, the relative effects of goal-directed, intravenous administration of crystalloid compared to colloid solutions on NT-proBNP and troponin T, especially in relatively healthy patients undergoing moderate- to high-risk noncardiac surgery, remains unclear.

Thus, the researchers evaluated in this sub-study the effect of a goal-directed crystalloid versus a goal-directed colloid fluid regimen on postoperative maximum NT-proBNP concentration.

Why It Was Studied

N-terminal pro brain natriuretic peptide (NT-proBNP) and troponin T are released during myocardial wall stress and/or ischemia and are strong predictors for postoperative cardiovascular complications.

The researchers further evaluated the incidence of myocardial injury after noncardiac surgery (MINS) between both study groups.

Who Took Part

According to the abstract, 4 patients were involved.

PubMed indexes the participants as middle-aged adults and older adults, both men and women.

Intraoperative fluid management was guided by oesophageal Doppler-according to a previously published algorithm.

How the Study Was Run

The design is described as randomized.

The patients were allocated by chance, so the BNP (Nesiritide) group and the comparison group should start out alike.

The primary outcome were differences in postoperative maximum NT-proBNP (maxNT-proBNP) between both groups.

As their secondary outcome the researchers evaluated the incidence of MINS between both study groups.

The researchers defined maxNT-proBNP as the maximum value measured within 2 h after surgery and on the first and second postoperative day.

What Was Measured

The researchers further evaluated the incidence of myocardial injury after noncardiac surgery (MINS) between both study groups.

The subject headings attached to it are Administration, Intravenous, Cardiovascular Diseases, Colloids, Crystalloid Solutions, Fluid Therapy, Goals and Hydroxyethyl Starch Derivatives.

The authors tagged it with the keywords Brain natriuretic peptide, Goal-directed fluid management and Troponin T.

What This Means in Plain Language

The paper is a randomized study of BNP (Nesiritide) in 4 patients.

With fewer than 40 people, it is a small study, so it is better read as an early signal for further research than as a settled answer.

Its findings take up roughly 4 sentences of the abstract and are left out here on purpose; the source paper is the place to read them.

The publication is from 2020 (BMC anesthesiology), a journal based in England.

More context: the BNP (Nesiritide) compound page, all human trials.