Nt-probnp as a Screening for Low-risk Patent Ductus Arteriousus: a Follow-up Validation Study

Abstract

Purpose: To test whether NT-proBNP serves as a screening for low-risk patent ductus arteriosus and safely avoids routine early echocardiography. Methods: Prospective observational study in preterm infants below 33 weeks of gestational age. Infants with >5100 pg/ml (positive screening) at 48-72 hours of life received comprehensive echocardiography and were treated according to shunt severity. Infants with NT-proBNP below 5100 pg/ml (negative screening) were managed expectantly. The main outcome was need for ductus treatment within the first 7 days of life. Result: 125 infants were included; 82 had a negative and positive NT-proBNP screening respectively. No infant (0%) with a negative screening was treated for ductus while 26 (60.4%) with a positive screening were treated (p<0.001). NT-proBNP avoided a 65.6% of routine echocardiograms. NT-proBNP had an excellent performance to predict treatment (AUC=0.967) Conclusions: NT-proBNP at 48-72 hours of life has an excellent performance to detect low-risk and avoids unnecessary echocardiograms. This may contribute to optimize PDA management in terms of resource utilization.