I agreed with Betadine's Opinion - BNP is not an important param

 BNP is not an important parameter to diagnose heart failure.

Although Brain Natriuretic Peptide can be one of the indicators for heart failure, while here it was more likely for the doctor to know whether the perfusion volume was proper or just good enough for this patient since the dialysis machine often requires a large blood volume to go though.

When atrium of a heart got overloaded, the atrium would release Atrial Natriuretic Peptide (ANP) to help diuretic. When ventricle of a heart got overloaded, then ventricle would release Brain Natriuretic Peptide (BNP). The doctor wanted to know weather the perfusion volume was O.K. since the patient had edema at lower extremeries. If the doctor really wanted to find out heart failure for this patient, he should have had got an ultrasonic technician to measure the the remaining volume of the left ventricle and the ejection percentage.

For dialysis patient, BNP is not a good parameter to diagnose heart failure, rather, a good parameter for the perfusion load. The doctor measured BNP for his technique need.

所有跟帖： 

• This patient is doing better now -禦用文人- ♀ (1659 bytes) () 05/09/2015 postreply 07:37:34

• An I.V blood given could help the patient further improvement -禦用文人- ♀ (330 bytes) () 05/09/2015 postreply 08:07:05

• 給力。頂。 -欲千北- ♂ (0 bytes) () 05/09/2015 postreply 09:42:23

• The doctor's words suggesting him to retire -禦用文人- ♀ (961 bytes) () 05/09/2015 postreply 16:10:21

• Orehek 醫生說的那句想怎麽享受就怎麽享受的話讓胖子聽出了絕望。他是很聽醫生的話的, 馬上就 -yankeeviv- ♀ (262 bytes) () 05/09/2015 postreply 17:54:05

• 謝謝禦醫解惑, 今天被胖子支使出醫院辦事去了, 沒有見到Orehek 醫生, 明天見到他一定按您的指教問清楚 -yankeeviv- ♀ (184 bytes) () 05/09/2015 postreply 16:14:08

• BNP is not only released from brain, but also from the ventricle -禦用文人- ♀ (234 bytes) () 05/09/2015 postreply 16:25:48

• Mainly, the doctor wanted to find out whether his design of dial -禦用文人- ♀ (232 bytes) () 05/09/2015 postreply 16:32:00

• 是啊, 也不知道腎醫Prior小組裏是不是合議做胖子的透析方案, 還是誰當班就誰做主。到目前為止, 效果不錯。 -yankeeviv- ♀ (363 bytes) () 05/09/2015 postreply 16:48:47

• 隻要不至於心衰就好。即便是心衰不要命也能接受。如果僅僅隻是因為之前volume overload, 那就邊治著腎, 邊觀察著 -yankeeviv- ♀ (0 bytes) () 05/09/2015 postreply 16:40:11

• Keep going and watching. So far so good. I am expecting his rec -禦用文人- ♀ (115 bytes) () 05/09/2015 postreply 16:56:21

• 你的金口禦言真是太讓人喜出望外了。眼下沒有心衰的跡象, 您的擲地有聲的金口神斷可讓我們的心情直衝雲宵了!!! -yankeeviv- ♀ (76 bytes) () 05/09/2015 postreply 17:08:31

• Don't trust any one on the earth, only trust the one on the sky. -禦用文人- ♀ (0 bytes) () 05/09/2015 postreply 17:15:25

• 遠水解不了近渴, 上帝離的太遠, 抓住您這個救命稻草肯定是不撒手了。胖子有沒有心衰都沒事, -yankeeviv- ♀ (65 bytes) () 05/09/2015 postreply 18:01:39