The effect of blood lactate and NT-proBNP predict the survival in patients with invasive mechanical ventilation

BACKGROUND: Respiratory failure is one of the most common critical diseases. It has already been reported that invasive mechanical ventilation (IMV) should be used to treat respiratory failure. The present study aims to evaluate the prognostic value of blood lactate and NT-proBNP in patients with IMV. METHODS: We retrospectively included 353 patients who were hospitalized in the emergency department of Shanghai Sixth People’s Hospital from 2016 to 2019. All patients had IMV. R&D Human Premixed Multi-Analyte Kit detected the expression of various inflammatory factors in serum. Receiver operating characteristic (ROC) curve analysis, survival analysis, and multivariate cox proportional hazards analysis were implemented as statistical analysis methods. RESULTS: The mean duration of hospitalization was 25.5±20.6 days. Twenty-four men and 41 women died. Compared with the survivors, the nonsurvivors were older, had different types of diagnosis, longer ventilation time, and shorter survival time (P<0.05). Also, the expression levels of PCT, NT-proBNP, lactate in 12 h and lactate in 24 h in the nonsurvivors were significantly higher than those in the survivor group (P<0.05). There was a significant correlation between these parameters and ventilation times (P<0.001). The results showed that age, NT-proBNP, and lactate were independent predictors of survival rate. ROC analysis showed that the cut-off values of age, NT-proBNP and lactate were 61.5 years, 230.5 pg/mL and 3.7 mmol/L, respectively. Patients aged ≥61.5 years or NT-proBNP ≥230.5 pg/mL or lactate ≥3.7 mmol/L had a worse prognosis. Therefore, patients with three parameters higher than cut-off value had the lowest survival rate, while patients with three parameters lower than cut-off value had the best survival rate. CONCLUSIONS: Blood lactate and NT-proBNP may be used as biomarkers to predict the prognosis of patients undergoing IMV.