BACKGROUND: Earlier and more accurate identification of a high-risk group of preterm infants that are likely to develop a hemodynamically significant patent ductus arteriosus (hsPDA) would allow specific targeting of early treatment and thus possibly minimize the morbidity and mortality associated with a PDA in extremely low birth weight (ELBW) infants. OBJECTIVE: To investigate the predictability of B-type natriuretic peptide (BNP) for early targeted treatment of hsPDA in ELBW infants. METHODS: 73 ELBW infants that underwent echocardiographic evaluation and plasma BNP measurement after birth were enrolled. 31 infants developed hsPDA (HsPDA group) and 42 infants did not develop hsPDA (nPDA group). RESULTS: BNP levels of the HsPDA group were significantly higher than those of the nPDA group at 24 h of age (921 [318-2,133] vs. 152 [91-450] pg/ml) but not different at 12 h of age. BNP levels at 24 h of age were significantly correlated with the magnitudes of the ductal shunt but not at 12 h of age. The area under the receiver operator characteristic curve of BNP levels for prediction of hsPDA at 24 h of age was 0.830. At the cutoff BNP levels of 200 and 900 pg/ml at 24 h of age, sensitivity was 83.9 and 54.8% and specificity was 61.9 and 95.2%, respectively. CONCLUSIONS: BNP levels at 24 h of age can be used as a guide for early targeted treatment of hsPDA and avoid the unnecessary use of cyclooxygenase inhibitors in ELBW infants.
BACKGROUND: Earlier and more accurate identification of a high-risk group of preterm infants that are likely to develop a hemodynamically significant patent ductus arteriosus (hsPDA) would allow specific targeting of early treatment and thus possibly minimize the morbidity and mortality associated with a PDA in extremely low birth weight (ELBW) infants. OBJECTIVE: To investigate the predictability of B-type natriuretic peptide (BNP) for early targeted treatment of hsPDA in ELBW infants. METHODS: 73 ELBW infants that underwent echocardiographic evaluation and plasma BNP measurement after birth were enrolled. 31 infants developed hsPDA (HsPDA group) and 42 infants did not develop hsPDA (nPDA group). RESULTS:BNP levels of the HsPDA group were significantly higher than those of the nPDA group at 24 h of age (921 [318-2,133] vs. 152 [91-450] pg/ml) but not different at 12 h of age. BNP levels at 24 h of age were significantly correlated with the magnitudes of the ductal shunt but not at 12 h of age. The area under the receiver operator characteristic curve of BNP levels for prediction of hsPDA at 24 h of age was 0.830. At the cutoff BNP levels of 200 and 900 pg/ml at 24 h of age, sensitivity was 83.9 and 54.8% and specificity was 61.9 and 95.2%, respectively. CONCLUSIONS:BNP levels at 24 h of age can be used as a guide for early targeted treatment of hsPDA and avoid the unnecessary use of cyclooxygenase inhibitors in ELBW infants.
Authors: Hani Yoo; Jin A Lee; Sohee Oh; Young Hwa Jung; Jin A Sohn; Seung Han Shin; Chang Won Choi; Ee Kyung Kim; Han Suk Kim; Beyong Il Kim Journal: J Korean Med Sci Date: 2017-01 Impact factor: 2.153
Authors: Jonathan L Slaughter; Clifford L Cua; Jennifer L Notestine; Brian K Rivera; Laura Marzec; Erinn M Hade; Nathalie L Maitre; Mark A Klebanoff; Megan Ilgenfritz; Vi T Le; Dennis J Lewandowski; Carl H Backes Journal: BMC Pediatr Date: 2019-09-13 Impact factor: 2.125
Authors: J Rafael Parra-Bravo; M Teresa Valdovinos-Ponce; Heladia García; Juan C Núñez-Enríquez; M Lourdes Jiménez-Cárdenas; Rodrigo Avilés-Monjaraz; Wendy Lavana-Hernández Journal: Arch Cardiol Mex Date: 2020-11-03