B-type natriuretic peptide: prognostic marker in congenital diaphragmatic hernia

Steurer, Martina A.; Moon-Grady, Anita J.; Fineman, Jeff; Sun, Christine; Lusk, Leslie A.; Wai, Katherine C.; Keller, Roberta L.

doi:10.1038/pr.2014.136

Cited by 31 publications

(19 citation statements)

References 30 publications

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“…18 In patients with PHT and CDH, BNP is a strong predictor of clinical outcome. [12][13][14][15][16][17][18][19][20] BNP levels are known to correlate with the gradient of the tricuspid regurgitation jet and the ratio of tricuspid regurgitation jet gradient to mean BP. Further, BNP is weakly correlated with OI.…”

Section: Discussionmentioning

confidence: 99%

Neonates Effects and Tolerability of Treprostinil in Hypertension with Persistent Pulmonary

et al. 2019

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Objective The aim of this study was to establish the effects of treprostinil in congenital diaphragmatic hernia (CDH) patients with persistent pulmonary hypertension (PHT) after 1 week of treatment. Drug effects were assessed by oxygenation index (OI), clinical end points, serial biochemical markers, and pre- and posttreatment echocardiogram. Treatment complications were also described. Study Design This is a quasi-experimental study of neonates with PHT admitted to the NICU within 48 hours showing persistent clinical instability, receiving mechanical ventilation with FiO2 > 60%, milrinone therapy, and inhaled nitric oxide. Clinical data were compared before and after treprostinil treatment. Results Seventeen neonates met the inclusion criteria. Median age was 17 days. Before treatment, median OI was 20 (IQR: 12–27). Suprasystemic PHT was estimated by echocardiogram in 8/17 patients; the rest were systemic. After 1 week of treatment, 15/17 patients were alive and median OI was 8 (IQR: 5–12, p = 0.0089). There were no statistically significant changes in laboratory data. Echocardiogram still showed suprasystemic PHT in 20% of patients. Adverse effects included hypotension, hematoma at the infusion site, and surgical persistent ductus arteriosus (PDA) closure in 4/17 patients. Fourteen patients were discharged. The median treatment time was 61 days. Conclusion Treprostinil was well tolerated with satisfactory clinical response. Further studies are required to identify early responder subgroups.

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Section: Discussionmentioning

confidence: 99%

Neonates Effects and Tolerability of Treprostinil in Hypertension with Persistent Pulmonary

et al. 2019

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“…However, other authors have reported an adequate correlation between the measurement of BNP on the first day of life of NBIs with diaphragmatic hernia and their clinical course. 35 The wide dispersion of BNP levels observed in the first week of life shows the important role played by BNP during transition to extrauterine life. 7 In our study, the isolated baseline BNP value also exhibited a wide dispersion among patients.…”

Section: Discussionmentioning

confidence: 99%

“…34,35 Likewise, it is necessary to study whether these outcomes are reproducible in other facilities.…”

Section: Discussionmentioning

confidence: 99%

B-type natriuretic peptide: Usefulness in the management of critically-ill neonates

et al. 2017

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B-type natriuretic peptide (BNP) is responsible for changes in the heart organogenesis and is associated with transition to extrauterine life. In the first week of life, BNP levels are high and return to normal with the physiological loss in weight. High BNP levels are associated with different conditions. Objective. To establish the relationship between BNP levels and criticality and the short-term clinical course among patients hospitalized in the neonatal intensive care unit. Method. Observational and analytical study conducted in a prospective cohort. Criticality was defined as a requirement for assisted mechanical ventilation with a fraction of inspired oxygen of more than 50% and/or inotropes. Two blood samples were collected 72 hours apart. Results. Seventy-three patients were included in the study. Depending on their clinical course on day 7, they were divided into 2 groups: patients with a good clinical course or a persistent, severe clinical course. The median baseline BNP level was similar in both groups (p: 0.15). The median BNP level at 72 hours was higher among patients with a persistent, severe clinical course (p: 0.005). The difference between both BNP values was calculated (∆BNP: BNP level at 72 hours -BNP level at 0 hours). The ∆BNP was positive among patients with a persistent, severe clinical course (X= 1260 pg/mL; range: 426-2094) and negative in the group with a good clinical course (X= -967 pg/mL; range: -1656/-278) (p: 0.0002); sensitivity: 87%; specificity: 86%; positive predictive value: 74%; and negative predictive value: 93%. Conclusion. In this group of patients, the delta-BNP value reflected the short-term clinical course.

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“…En cambio, otros autores reportaron buena correlación entre el dosaje de PNB el primer día de vida de niños con hernia diafragmática y su evolución. 35 La amplia dispersión de los valores de PNB, hallada en la primera semana de vida, muestra el importante rol del PNB durante la transición a la vida extrauteriana. 7 En nuestro estudio, el valor aislado de PNB inicial también mostró una amplia dispersión entre los pacientes.…”

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Péptido natriurético tipo B: utilidad en el manejo de recién nacidos críticamente enfermos

et al. 2017

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RESUMENEl péptido natriurético B (PNB) es un péptido responsable de los cambios durante la organogénesis del corazón y en la transición a la vida extrauterina. En la primera semana de vida, los niveles de PNB son altos y se normalizan con el descenso fisiológico del peso. Valores elevados de PNB se han asociado a diferentes patologías. Objetivo. Establecer la relación entre los niveles de PNB y la criticidad y evolución a corto plazo en pacientes internados en la Unidad de Cuidados Intensivos Neonatales. Método. Estudio observacional analítico de una cohorte prospectiva. Se definió criticidad como requerimientos de asistencia respiratoria con fracción inspirada de oxígeno mayor del 50% y/o inotrópicos. Se extrajeron 2 muestras de sangre con 72 h de diferencia. Resultados. Ingresaron 73 pacientes. Según la evolución al séptimo día del ingreso, se los dividió en 2 grupos: pacientes con buena evolución o con evolución grave persistente. La mediana del PNB inicial fue similar en ambos grupos (p: 0,15). La mediana de PNB a las 72 h fue mayor en los pacientes con evolución grave persistente (p: 0,005). Se calculó la diferencia entre ambos valores de PNB (∆PNB: valor de PNB a las 72 h -valor de PNB a la hora cero). El ∆PNB presentó valores positivos en los pacientes con evolución grave persistente (X= 1260 pg/ml; rango: 426-2094) y valores negativos en el grupo con buena evolución (X= -967 pg/ml; rango: -1656/-278) (p: 0,0002); sensibilidad: 87%; especificidad: 86%; valor predictivo positivo: 74%; y valor predictivo negativo: 93%. Conclusión. En este grupo de pacientes, el delta de PNB reflejó la evolución a corto plazo. Palabras clave: péptido natriurético B, recién nacido.

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B-type natriuretic peptide: prognostic marker in congenital diaphragmatic hernia

Cited by 31 publications

References 30 publications

Neonates Effects and Tolerability of Treprostinil in Hypertension with Persistent Pulmonary

Neonates Effects and Tolerability of Treprostinil in Hypertension with Persistent Pulmonary

B-type natriuretic peptide: Usefulness in the management of critically-ill neonates

Péptido natriurético tipo B: utilidad en el manejo de recién nacidos críticamente enfermos

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