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Name of Media:

Negative B natriuretic peptide testing confirms low risk stratification for patients with a definite pulmonary embolus

Author(s):

Craig Ferguson

Publisher or Source:

BestBETS

Type of Media:

Medical Professional Education

Media Originally for:

Critical Care Physicians

Country of Origin:

United Kingdom of Great Britain and Northern Ireland (the)

Primary Focus of Media:

Pre-Use of PICS Designation

COVID-19 Related:

No

Description:

Three Part Question
In [patients with definite pulmonary embolus] can a [low/negative BNP/NT-proBNP result] predict [low risk of death / adverse outcome?]
Clinical Scenario
A patient presents with a few days history of pleuritic chest pain. All clinical findings and investigations are normal except for a raised d-dimer. A high probability V/Q scan confirms the diagnosis of pulmonary embolism. The patient is very keen to be discharged. You are aware that right ventricular strain is associated with a poor outcome in pulmonary embolism and you also know that B natriuretic peptides are raised in the presence of ventricular strain. You wonder if a low B natriuretic peptide level could be used to confirm the absence of ventricular stain and low risk of death or serious complications, therefore suggesting suitability for outpatient management.
Search Strategy
Cochrane Database of Systematic Reviews, EMBASE and Ovid Medline through Ovid interface, January 2015.

[bnp.mp. OR brain natriuretic peptide.mp. OR natriuretic peptide.mp. OR NT-proBNP.mp. OR proBNP.mp.] AND [pulmonary embolism.mp. OR pe.mp. OR thromboembolic disease.mp. OR lung embolism.mp.] LIMIT to english language and human (Limit not valid in CDSR)

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