{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T10:08:26Z","timestamp":1792750106342,"version":"4.5.0"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2012,12,1]],"date-time":"2012-12-01T00:00:00Z","timestamp":1354320000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,12,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>Difficult weaning from mechanical ventilation is often associated with fluid overload. B-type natriuretic peptide (BNP) has been proposed as a tool for predicting and detecting weaning failure of cardiovascular origin.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To investigate whether fluid management guided by daily BNP plasma concentrations improves weaning outcomes compared with empirical therapy dictated by clinical acumen.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In a randomized controlled multicenter study, we allocated 304 patients to either a BNP-driven or physician-driven strategy of fluid management during ventilator weaning. To standardize the weaning process, patients in both groups were ventilated with an automatic computer-driven weaning system. The primary end point was time to successful extubation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>In the BNP-driven group, furosemide and acetazolamide were given more often and in higher doses than in the control group, resulting in a more negative median (interquartile range) fluid balance during weaning (\u20132,320 [\u20134,735, 738] vs. -180 [\u20132,556, 2,832] ml; P &amp;lt; 0.0001). Time to successful extubation was significantly shorter with the BNP-driven strategy (58.6 [23.3, 139.8] vs. 42.4 [20.8, 107.5] h; P = 0.034). The BNP-driven strategy increased the number of ventilator-free days but did not change length of stay or mortality. The effect on weaning time was strongest in patients with left ventricular systolic dysfunction. The two strategies did not differ significantly regarding electrolyte imbalance, renal failure, or shock.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our results suggest that a BNP-driven fluid management strategy decreases the duration of weaning without increasing adverse events, especially in patients with left ventricular systolic dysfunction.<\/jats:p>\n                    <jats:p>Clinical trial registered with www.clinicaltrials.gov (NCT00473148).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1164\/rccm.201205-0939oc","type":"journal-article","created":{"date-parts":[[2012,9,21]],"date-time":"2012-09-21T02:01:26Z","timestamp":1348192886000},"page":"1256-1263","source":"Crossref","is-referenced-by-count":145,"title":["Natriuretic Peptide\u2013driven Fluid Management during Ventilator Weaning: A Randomized Controlled Trial"],"prefix":"10.1093","volume":"186","author":[{"given":"Armand Mekontso","family":"Dessap","sequence":"first","affiliation":[{"name":"Assistance Publique-H\u00f4pitaux de Paris (AP-HP), Centre Hospitalier Universitaire (CHU) Henri Mondor, Service de R\u00e9animation M\u00e9dicale, Cr\u00e9teil, France"},{"name":"Universit\u00e9 Paris Est Cr\u00e9teil, Facult\u00e9 de M\u00e9decine, Cr\u00e9teil, France"},{"name":"Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale (INSERM), Unit\u00e9 U955, Cr\u00e9teil, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ferran","family":"Roche-Campo","sequence":"additional","affiliation":[{"name":"Assistance Publique-H\u00f4pitaux de Paris (AP-HP), Centre Hospitalier Universitaire (CHU) Henri Mondor, Service de R\u00e9animation M\u00e9dicale, Cr\u00e9teil, France"},{"name":"Hospital de Sant Pau, Servei de Medicina Intensiva, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Achille","family":"Kouatchet","sequence":"additional","affiliation":[{"name":"CHU d\u2019Angers, Service de R\u00e9animation M\u00e9dicale, Angers, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinko","family":"Tomicic","sequence":"additional","affiliation":[{"name":"Clinica Alemana, Departamento de Paciente Cr\u00edtico, Santiago de Chile, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaetan","family":"Beduneau","sequence":"additional","affiliation":[{"name":"CHU de Rouen, Service de R\u00e9animation M\u00e9dicale and Unit\u00e9 Propre de Recherche et de l\u2019Enseignement Sup\u00e9rieur, Equipe d\u2019Accueil (UPRES-EA) 3830, Rouen, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romain","family":"Sonneville","sequence":"additional","affiliation":[{"name":"AP-HP, CHU Bichat-Claude Bernard, Service de R\u00e9animation M\u00e9dicale et des Maladies Infectieuses, Universit\u00e9 Paris Diderot, Sorbonne Paris Cit\u00e9, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Belen","family":"Cabello","sequence":"additional","affiliation":[{"name":"Hospital de Sant Pau, Servei de Medicina Intensiva, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samir","family":"Jaber","sequence":"additional","affiliation":[{"name":"CHU Saint Eloi, D\u00e9partement d\u2019Anesth\u00e9sie R\u00e9animation B, INSERM U1046, Montpellier, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elie","family":"Azoulay","sequence":"additional","affiliation":[{"name":"AP-HP, CHU Saint Louis, Service de R\u00e9animation M\u00e9dicale, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Castanares-Zapatero","sequence":"additional","affiliation":[{"name":"H\u00f4pital Universitaire Saint-Luc, Service de Soins Intensifs, Bruxelles, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerome","family":"Devaquet","sequence":"additional","affiliation":[{"name":"H\u00f4pital Foch, Service de R\u00e9animation, Suresnes, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois","family":"Lellouche","sequence":"additional","affiliation":[{"name":"Institut Universitaire de Cardiologie et de Pneumologie de Qu\u00e9bec, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandrine","family":"Katsahian","sequence":"additional","affiliation":[{"name":"AP-HP, CHU Henri Mondor, Unit\u00e9 de Recherche Clinique, Cr\u00e9teil, France; 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