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 -御用文人- ♀ (1659 bytes) () 05/09/2015 postreply 07:37:34

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

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

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

• Orehek 医生说的那句想怎么享受就怎么享受的话让胖子听出了绝望。他是很听医生的话的, 马上就 -yankeeviv- ♀ (262 bytes) () 05/09/2015 postreply 17:54:05

• 谢谢御医解惑, 今天被胖子支使出医院办事去了, 没有见到Orehek 医生, 明天见到他一定按您的指教问清楚 -yankeeviv- ♀ (184 bytes) () 05/09/2015 postreply 16:14:08

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

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

• 是啊, 也不知道肾医Prior小组里是不是合议做胖子的透析方案, 还是谁当班就谁做主。到目前为止, 效果不错。 -yankeeviv- ♀ (363 bytes) () 05/09/2015 postreply 16:48:47

• 只要不至于心衰就好。即便是心衰不要命也能接受。如果仅仅只是因为之前volume overload, 那就边治着肾, 边观察着 -yankeeviv- ♀ (0 bytes) () 05/09/2015 postreply 16:40:11

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

• 你的金口御言真是太让人喜出望外了。眼下没有心衰的迹象, 您的掷地有声的金口神断可让我们的心情直冲云宵了!!! -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. -御用文人- ♀ (0 bytes) () 05/09/2015 postreply 17:15:25

• 远水解不了近渴, 上帝离的太远, 抓住您这个救命稻草肯定是不撒手了。胖子有没有心衰都没事, -yankeeviv- ♀ (65 bytes) () 05/09/2015 postreply 18:01:39