Comparison between N-terminal pro-B-type Natriuretic Peptide and C-Reactive Protein as Prognostic Markers in Severe Sepsis and Septic Shock

Abstract

Sepsis is a leading cause of death in critically ill patients despite the use of modern antibiotics and resuscitation therapies. The septic response is an extremely complex chain of events involving inflammatory and anti-inflammatory processes, humeral and cellular reactions and circulatory abnormalities (Gullo et. al., 2006). Accurate and rapid diagnosis of infection is important so that appropriate treatment can be initiated early. However, because of prior or current antibiotic therapy, cultures often yield negative results, and multiple comorbidities can complicate diagnosis (Kumar et. al., 2006). The diagnosis of sepsis is thus largely based on clinical suspicion supported by the presence of several signs of sepsis. Laboratory markers of sepsis would represent a key advance in diagnosis and monitoring disease severity and recovery. However, although many agents have been proposed as sepsis biomarkers, none of them is sufficiently specific or sensitive to be used routinely for diagnosis (Pierrakos et. al., 2010). The diagnostic and prognostic use of natriuretic peptides in the intensive care setting for patients with various forms of shock could be an attractive alternative as noninvasive markers