Successful Management of Pulmonary Arterial Hypertension by Monitoring N-Terminal Pro-B-Type Natriuretic Peptide Serum Levels in a Preterm Infant with Chronic Lung Disease: A Case Report

Seki, Keigo; Iwashima, Satoru; Uchiyama, Hiroki; Ohishi, Akira; Ishikawa, Takamichi

doi:10.1055/s-0039-1684026

Cited by 2 publications

(1 citation statement)

References 15 publications

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“…PH can worsen the prognosis of premature infants with BPD considerably. Infants with BPD and PH have much higher morbidity and mortality rates than those with BPD only[ 3 , 5 , 6 ]. PH increases the mortality of infants with BPD by up to 50%[ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Successful treatment of pulmonary hypertension in a neonate with bronchopulmonary dysplasia: A case report and literature review

Li¹,

Zhao²,

Yang³

et al. 2022

World J Clin Cases

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BACKGROUND Pulmonary hypertension (PH) is a severe complication of bronchopulmonary dysplasia (BPD) in premature neonates and is closely related to prognosis. However, there is no effective and safe treatment for PH due to BPD in infants. Successful treatment for cases of BPD-associated PH with Tadalafil combined with bosentan is rare. This case may make a significant contribution to the literature because PH is difficult to manage as a serious complication of BPD in preterm infants. Mortality is high, especially when it is complicated by heart failure. CASE SUMMARY An extremely premature neonate with a gestational age of 26 +5 wk and birth weight of 0.83 kg was diagnosed with BPD associated with PH; oral sildenafil did not improve the PH. The infant experienced sudden cardiac arrest and serious heart failure with severe PH. After a series of treatments, including cardiopulmonary resuscitation, mechanical ventilation, and inhaled nitric oxide (iNO), the respiratory and circulatory status improved but the pulmonary artery pressure remained high. Then oral sildenafil was replaced with oral tadalafil and bosentan; pulmonary artery pressure improved, and the infant recovered at our hospital. After 2 years of follow-up, she is in good condition, without any cardiovascular complications. CONCLUSION INO can effectively improve the respiratory and circulatory status of infants with PH associated with premature BPD. B-type natriuretic peptide should be routinely measured during hospitalization to evaluate the risk and prognosis of BPD-associated PH in preterm infants. Tadalafil combined with bosentan for the treatment of PH associated with premature BPD was better than sildenafil in this case. Further studies are needed to explore the efficacy and safety of different vasodilators in the treatment of PH associated with premature BPD.

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Section: Introductionmentioning

confidence: 99%

Successful treatment of pulmonary hypertension in a neonate with bronchopulmonary dysplasia: A case report and literature review

Li¹,

Zhao²,

Yang³

et al. 2022

World J Clin Cases

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Cord Blood Procalcitonin and N-terminal Pro-brain Natriuretic Peptide: Biomarkers for Early Prediction of Bronchopulmonary Dysplasia

Cui

2023

Preprint

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Background: This study focused on determining whether cord blood procalcitonin (PCT) and N-terminal pro-brain natriuretic peptide (NT-proBNP) concentrations could accurately predict bronchopulmonary dysplasia (BPD) in preterm infants. Methods: Overall, 452 preterm infants were included in this prospective cohort trial and were divided into groups according to their BPD diagnoses. We evaluated PCT and NT-proBNP concentrations in cord blood. The effectiveness of determining cord blood PCT and NT-proBNP concentrations in predicting BPD was assessed using the receiver operating characteristic curve analysis. Multivariable logistic regression analyses and mediation analyses were used to analyze the risk variables for BPD and the associations of the two biomarkers with perinatal factors and neonatal outcomes. Results: Concentrations of the two biomarkers were greater in the cord blood of preterm infants with BPD than in the No-BPD group (P < 0.001). The appropriate cutoff values for cord blood PCT and NT-proBNP to predict BPD were 0.28 ng/mL and 2,460.50 pg/mL, respectively. In the multivariable logistic regression analysis, fetal inflammatory response syndrome (FIRS), respiratory distress syndrome, and the two cord blood biomarker levels were identified as significant risk factors for BPD (odds ratio [OR] = 1.55–3.72). The concentration of cord blood PCT accounted for 26.4% and 34.6% of the association between FIRS and chorioamnionitis with BPD, respectively. The two cord blood biomarkers were found to be strongly associated with the incidence of neonatal outcomes (OR = 1.27–2.58). Conclusions: Cord blood PCT and NT-proBNP concentrations may be valuable noninvasive predictive indicators of BPD development in preterm newborns. Trial registration: This study was registered on the website http://www.chictr.org.cn/listbycreater.aspx (number ChiCTR2100052175).

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Successful Management of Pulmonary Arterial Hypertension by Monitoring N-Terminal Pro-B-Type Natriuretic Peptide Serum Levels in a Preterm Infant with Chronic Lung Disease: A Case Report

Cited by 2 publications

References 15 publications

Successful treatment of pulmonary hypertension in a neonate with bronchopulmonary dysplasia: A case report and literature review

Successful treatment of pulmonary hypertension in a neonate with bronchopulmonary dysplasia: A case report and literature review

Cord Blood Procalcitonin and N-terminal Pro-brain Natriuretic Peptide: Biomarkers for Early Prediction of Bronchopulmonary Dysplasia

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