1
|
Sahu S, Shah DN, Vempati R, Kandhi PR, Parmar MP, Bethanabotla S, Gadgil S, Chandra P, Malipatil SN, Patel Y, Natarajan B, Bingi TC. Rapid N-Terminal Pro-B-Type Natriuretic Peptide (NT-proBNP) Kit as a Differentiating Tool for Acute Dyspnea in a Resource-Limited Setting. Cureus 2023; 15:e48306. [PMID: 38058332 PMCID: PMC10697234 DOI: 10.7759/cureus.48306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 11/05/2023] [Indexed: 12/08/2023] Open
Abstract
Introduction Dyspnea is among the most prevalent symptoms experienced by patients presenting as an emergency. The underlying etiology is often a cardiovascular or pulmonary condition, of which heart failure is recognized as a major contributor. The differentials are primarily established based on the patient's clinical presentation and physical examinations but are not conclusive. Of the various investigations undertaken to determine the cause of dyspnea, the biomarker N-Terminal Pro-B-Type Natriuretic Peptide (NT-proBNP) was found to be significantly associated with heart failure. Its level has been proven to be in direct correlation with the severity of the disease. This study demonstrates the usability of an economical rapid test kit in measuring NT-ProBNP levels to help differentiate the cause of dyspnea in the presenting patient in a resource-limited setting. Methodology We studied 115 participants from a tertiary care center in India, which included 70 males and 45 females aged ≤30 to ≥75 years, presenting with shortness of breath. Rapid NT-ProBNP tests were conducted alongside recording their symptoms, vitals, examination findings, and other parameters. They were also classified according to New York Heart Association (NYHA) Classification, and further investigated. Results The study elucidated the efficacy and accuracy of the rapid kits in determining NT-ProBNP levels, and its relation with the severity and prognosis of heart failure. The kits utilized had a sensitivity of greater than 93% for ruling out heart failure as a cause of dyspnea, and a sensitivity of greater than 96% for ruling out elevated NT-ProBNP levels in general. Other parameters such as presenting symptoms and vitals were also analyzed, establishing a correlation with NT-ProBNP levels. Conclusion This study guided us in understanding the effective utilization of the rapid testing kits for emergency care, minimizing the burden on other limited resources. The lower cost and ease of use would serve as a quick means of reaching a conclusive diagnosis, especially in an emergency, which in turn would aid in receiving timely and specific treatment. These kits could act as a stepping stone in creating a sustainable and efficient healthcare system for patients as well as healthcare workers.
Collapse
Affiliation(s)
- Sweta Sahu
- Surgery, JJM (Jagadguru Jayadeva Murugarajendra) Medical College, Davanagere, IND
| | - Devarsh N Shah
- Medicine and Surgery, Medical College Baroda, Vadodara, IND
| | - Roopeessh Vempati
- Internal Medicine, Gandhi Medical College, Secunderabad, IND
- Cardiology, Heart & Vascular Institute, Detroit, USA
| | | | - Mihirkumar P Parmar
- Internal Medicine, Gujarat Medical Education and Research Society, Vadnagar, IND
| | | | - Shardool Gadgil
- Medicine and Surgery, Lokmanya Tilak Municipal General Hospital and Medical College, Mumbai, IND
| | - Prerna Chandra
- Internal Medicine, Deccan College of Medical Sciences, Hyderabad, IND
| | | | - Yash Patel
- Internal Medicine, Gujarat Medical Education and Research Society, Vadnagar, IND
| | | | | |
Collapse
|
2
|
Shafi M. Differentiating Cardiac and Pulmonary Causes of Dyspnea: Is Point-of-care Ultrasound the Ultimate Tool? Indian J Crit Care Med 2022; 26:7-8. [PMID: 35110834 PMCID: PMC8783231 DOI: 10.5005/jp-journals-10071-24098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
How to cite this article: Shafi M. Differentiating Cardiac and Pulmonary Causes of Dyspnea: Is Point-of-care Ultrasound the Ultimate Tool? Indian J Crit Care Med 2022;26(1):7-8.
Collapse
Affiliation(s)
- Mozammil Shafi
- Department of Intensive Care Unit, King Salman Hospital, Riyadh, Saudi Arabia
| |
Collapse
|