A new guide focused on when to use NT-pro-BNP tests and transthoracic echocardiogram in preoperative assessment of patients is now available to download.

The guidance is the first in a series aimed at ensuring preoperative diagnostic testing is only used where the results are likely to change perioperative management by anaesthetists.  

GIRFT reviews – along with a recent audit and work with the POA non-medical network – have shown that high levels of preoperative testing are slowing surgical pathways and increasing demand on diagnostic services.   

NT-proBNP is a protein that plays a crucial role in diagnosing and monitoring heart conditions, particularly heart failure. Elevated NT-proBNP can be used as the first step investigation for patients presenting with heart failure signs and symptoms. Doing this test may reduce demand for echocardiogram preoperatively. 

This guide advises on when to use these two tests in preoperative assessment in order to avoid unnecessary use. It includes clinical scenarios illustrating when to use echocardiography and NT-pro-BNP tests, and information on decision support tools, and the management of results.