NPPB and acute respiratory distress syndrome: Biventricular dysfunction resulting from proinflammatory cytokine action on the myocardium, volume overload as a result of resuscitation protocols, and impaired renal function, alongside ARDS and mechanical ventilation, ultimately, lead to RV dysfunction, have all been considered as factors that lead to BNP overproduction [3] In severe sepsis, increased BNP levels and poorer outcomes have been attributed to cardiac involvement [29].