N-terminal probrain natriuretic peptide and patent ductus arteriosus in preterm infants

Nuntnarumit, Pracha; Khositseth, Anant; P, Thanomsingh

doi:10.1038/jp.2008.185

Cited by 37 publications

(35 citation statements)

References 36 publications

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“…[89] Infants with HsPDA were treated with indomethacin, ibuprofen or surgery depending on the clinical status of the infant and discretion of the neonatologist.…”

Section: Methodsmentioning

confidence: 99%

NT-proBNP levels improve the ability of predicting a hemodynamically significant patent ductus arteriosus in very low-birth-weight infants

et al. 2012

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Purpose:A hemodynamically significant Patent ductus arteriosus (HsPDA) in premature infants is known to be associated with significant morbidity. Recently brain natriuretic peptides and superior mesenteric artery (SMA)-resistive indices have been used to effectively diagnose HsPDA.Objective:To assess the sensitivity and specificity of N-terminal proBNP (NT-proBNP) in predicting an HsPDA diagnosed by clinical and echocardiographic criteria including pulsatility index (PI) of SMA.Materials and Methods:All preterm neonates <1500 g were evaluated with echocardiograms and NT-proBNP levels on the 3rd to 5th day of life and then every week until the echo showed either a closed PDA or non-HsPDA.Results:Sixty-nine babies with mean gestational age of 27 weeks were included in the study. NT-proBNP levels were significantly higher in the HsPDA group (n=22) with a mean±SEM of 24420±3190 compared to 3072±332 in the non-HsPDA group (n=47) (P<0.001). NT-pro BNP level of 5900 pg/ml had 96% sensitivity and 90% specificity of predicting HsPDA.Conclusions:With frequently changing hemodynamics in low-birth weight infants, including NT-proBNP and PI of SMA improve the ability of assessing the effects of a HsPDA and will help timing of intervention.

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“…[89] Infants with HsPDA were treated with indomethacin, ibuprofen or surgery depending on the clinical status of the infant and discretion of the neonatologist.…”

Section: Methodsmentioning

confidence: 99%

NT-proBNP levels improve the ability of predicting a hemodynamically significant patent ductus arteriosus in very low-birth-weight infants

et al. 2012

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“…Early detection of echocardiographic hsPDA would need a skillful pediatric cardiologist. Studies on brain natriuretic peptides (BNP) in early detection of hsPDA have been reported [13,14,15]. Holmström et al [13] found that N-terminal-pro BNP may provide clinically relevant information in the hemodynamic assessment of preterm infants with hsPDA.…”

Section: Discussionmentioning

confidence: 99%

Perfusion Index as a Diagnostic Tool for Patent Ductus Arteriosus in Preterm Infants

Khositseth

Muangyod²,

Nuntnarumit³

2013

Neonatology

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Background: Perfusion index (PI) could reflect peripheral flow. Preterm infants with hemodynamically significant patent ductus arteriosus (hsPDA) will have left-to-right shunt across PDA causing less blood flow to the lower legs. Objective: To evaluate pre- and postductal PI differences (ΔPI) in hsPDA. Methods: Preterm infants with gestational age <34 weeks were assessed for ΔPI on days 1, 3, and 7 of life with simultaneous echocardiography. Based on echocardiography, each infant was categorized into hsPDA, non-hsPDA, and no PDA. Results: Thirty infants (16 males), median age 31 weeks (interquartile range, IQR, 29-32) and weight 1,490 g (IQR 1,100-1,670) were enrolled. On days 1 and 3 of life, the ΔPI of infants with hsPDA (1.57%, IQR 0.28-2.32, n = 14, and 1.32%, IQR 0.28-1.83, n = 10) were significantly higher than those without hsPDA (0.14%, IQR -0.03 to 0.30, n = 16, and 0.08%, IQR -0.07 to 0.26, n = 20), p = 0.009 and 0.005, respectively. At all time points (days 1, 3, and 7 of life, n = 84), ΔPI >1.05% had sensitivity, specificity, positive predictive value, and negative predictive value of 66.7, 100, 100, and 86.4%, respectively, to detect hsPDA. Conclusion: The pre- and postductal PI differences were significantly related to the hemodynamic changes of PDA and might be useful to detect hemodynamically significant PDA.

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“…The area under the curve was higher for NGAL on days 0-1 than it was on days 2-4. In earlier studies, days 2-3 of life proved to be the optimal time point for the determination of NT-proBNP [27] . For clinical use, the optimal diagnostic window for hsPDA is within the first hours of life.…”

Section: Discussionmentioning

confidence: 99%

Urinary NT-proBNP, NGAL, and H-FABP May Predict Hemodynamic Relevance of Patent Ductus Arteriosus in Very Low Birth Weight Infants

Tosse¹,

Pillekamp²,

Verde

et al. 2012

Neonatology

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Background: Hemodynamically significant patent ductus arteriosus (hsPDA) is the most common functional cardiovascular disease in preterm infants. The necessity to treat hsPDA can neither be derived solely from clinical nor from echocardiographic criteria. Objective: The aim of this study was to establish non-invasive parameters which can differentiate hsPDA from non-hsPDA. Methods: Urinary protein levels of NT-proBNP, NGAL, and H-FABP were measured and correlated with the necessity of therapy for PDA. In 37 neonates (<1,500 g), urinary protein concentrations were tested on days 0, 2, and 7 by ELISA methodology. Of 37 infants, 12 required therapeutic interventions according to current treatment standards. Results: Infants receiving an intervention for PDA showed significantly higher levels of pro-BNP, NGAL, and H-FABP at all time points except for NT-proBNP on day 0. Infants requiring a second or third course of ibuprofen had significantly higher levels of H-FABP and NGAL. In all samples, the concentration of the three proteins correlated positively with each other. Conclusions: The present study shows that measurement of urinary proteins is a powerful and non-invasive method to quantify the effect of PDA on systemic perfusion in preterm infants. Furthermore, NGAL and H-FABP may be used to indicate the necessity of pharmacological or surgical treatment of PDA.

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N-terminal probrain natriuretic peptide and patent ductus arteriosus in preterm infants

Cited by 37 publications

References 36 publications

NT-proBNP levels improve the ability of predicting a hemodynamically significant patent ductus arteriosus in very low-birth-weight infants

NT-proBNP levels improve the ability of predicting a hemodynamically significant patent ductus arteriosus in very low-birth-weight infants

Perfusion Index as a Diagnostic Tool for Patent Ductus Arteriosus in Preterm Infants

Urinary NT-proBNP, NGAL, and H-FABP May Predict Hemodynamic Relevance of Patent Ductus Arteriosus in Very Low Birth Weight Infants

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