BNP Testing in Patients With SOB on Presentation to ED
BNP Testing in Patients With SOB on Presentation to ED
A trial to examine whether a new heart failure blood test can improve the outcome of patients
 presenting to the Emergency Department with shortness of breath.

 We hypothesise that a BNP test performed in real-time in patients presenting to the Emergency
 Department with shortness of breath will help identify additional patients with CHF and
 consequently to change practice and allow more patients to recieve correct treatment earlier.
In recent years new tests to diagnose heart failure have become available. We are evaluating
 a new test called B-type natriuretic peptide(BNP)in patients presenting to the Emergency
 Department with shortness of breath. Patients are randomised into whether they will receive
 the new test or not. In the patient group where the test is positive, standardised approach
 that will optimise heart failure treatment will be introduced. We hypothesise that with this
 approach we will improve the clinical care of patients who present to the Emergency
 Department with shortness of breath. Measures of outcomes will be the accuracy of diagnosis 2
 hours after presentation, 30 day mortality, hospital and ICU admission rates and quality of
 life at 30days.

 We plan to investigate 600 consecutive patient presenting to the to the Emergency Department
 with shortness of breath that are over 40 years old and present with an emergency department
 triage category of 3 or higher. Patients presenting with a traumatic cause of dyspnea,
 patients with severe renal disease, patients with cardiogenic shock and patients who have
 early transfer to another hospital(within 24 hrs) will be excluded.
Inclusion Criteria:

 We plan to include all patients presenting to the ED with shortness of breath that are over
 40 years old and present with an emergency department triage category of 3 or higher.

 Exclusion Criteria:

 Patients presenting with a traumatic cause of dyspnea, patients with severe renal disease
 (serum creatinine level of more than 250 micro mmol/L, patients with cardiogenic shock, and
 patients who have an early transfer to another hospital (within 24 hrs) will be excluded.