Association Between NT-proBNP and Prolonged Length of Stay in Hospital Among Preterm Infants Born at 28–31 Weeks' Gestation

Ge, Jian; Luo, Chenghan; Lei, Mengyuan; Shi, Zhang; Cheng, Xinru; Zhao, Min; Zhao, Yang; Song, Min Seob; Ding, Wenqian; Wang, Mengmeng; Cao, Wenjun; Mao, Fengxia; Han, Suge; Xu, Qiao; Wang, Junbo; Qin, Haoqi; Wang, Li; Zhang, Qian

doi:10.3389/fped.2021.783900

Cited by 5 publications

(11 citation statements)

References 32 publications

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“…Measuring NT-proBNP immediately after the extubation (0-60 min) certainly will lead to an underestimation of NT-proBNP release by cardiomyocytes, which will be induced due to changes in atrial/ventricular pressures.We could demonstrate that NT-proBNP abs and NT-proBNP Zlog values were significantly correlated with the severity of PH in critically ill neonates. This is in line with previous findings, as described in neonatal studies on infants suffering from congenital diaphragmatic hernia (CDH) or preterm infants at risk/or suffering from bronchopulmonary dysplasia (BPD) 9,10,22,23. Additionally, NT-proBNP Zlog values after the extubation significantly correlated with RVD and LVD.…”

supporting

confidence: 92%

NT‐proBNP and Zlog‐transformed NT‐proBNP values predict extubation failure in critically ill neonates with pulmonary hypertension and ventricular dysfunction

Schroeder¹,

Kuelshammer²,

Dolscheid‐Pommerich

et al. 2022

Pediatric Pulmonology

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Objectives: Critically ill neonates with a history of pulmonary hypertension (PH) or ventricular dysfunction are at risk to experience an extubation failure (EF) after liberation from mechanical ventilation (MV). Due to insufficient data from neonatal cohorts, it remains unclear whether NT-proBNP is an appropriate biomarker to predict EF in this cohort. The Zlog-transformation of NT-proBNP (further named NT-proBNP Zlog ) is an additional tool to optimize the interpretation of NT-proBNP since absolute NT-proBNP values are varying with the age of these infants.Patients and Methods: This was a retrospective single-center analysis at the University Children's Hospital, Bonn, Germany, during the study period from January 2020 until December 2021. Forty-three neonates met the inclusion criteria and were screened for study participation. Inclusion criteria: prolonged (>24 h) MV with at least one extubation attempt, with a history of PH and/or ventricular dysfunction in the echocardiographic assessment at admission to the neonatal intensive care unit or during the period of MV, NT-proBNP measurements before (max. 24 h, baseline) and after (max. 24 h, follow-up) the first extubation attempt. The primary clinical endpoint was defined as EF with need for reintubation (0-72 h). Neonates with an EF were allocated to group A and neonates with successful liberation from MV to group B.Main Results: The primary clinical endpoint (EF) was reached in 21% (nine infants).Absolute mean NT-proBNP values (NT-proBNP abs ) at baseline did not differ significantly in infants of group A and B (6931 vs. 7136 pg/ml, p = 0.227).NT-proBNP Zlog values at baseline (2.35 vs. 1.57, p = 0.073) tended to higher values in group A. NT-proBNP abs values measured at follow-up were significantly higher in infants allocated to group A (11120 vs. 7570 pg/ml, p = 0.027). Likewise, NT-proBNP Zlog values at follow-up were significantly higher in infants allocated to group A (3.05 vs. 1.93, p = 0.009). NT-proBNP abs values at follow-up and NT-proBNP Zlog values at baseline correlated significantly with the severity of PH.

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supporting

confidence: 92%

NT‐proBNP and Zlog‐transformed NT‐proBNP values predict extubation failure in critically ill neonates with pulmonary hypertension and ventricular dysfunction

Schroeder¹,

Kuelshammer²,

Dolscheid‐Pommerich

et al. 2022

Pediatric Pulmonology

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“…Of these studies, four were prospective studies ( 24 – 27 ) and the remaining 19 studies were retrospective ( 1 , 9 , 18 , 28 – 43 ), of which 14 were multicenter studies ( 9 , 24 , 25 , 27 – 29 , 31 , 33 – 35 , 37 – 39 , 42 ) and 9 were single-center studies ( 1 , 18 , 26 , 30 , 32 , 36 , 40 , 41 , 43 ). The sample size ranged from 191 to 7,60,037.…”

Section: Resultsmentioning

confidence: 99%

“…The studies investigated a range of newborns with different gestational ages and different birth weights, of which seven studies were conducted with preterm infants as respondents ( 1 , 9 , 24 , 33 , 36 , 38 , 41 ); four studies were conducted in low birth weight infants as respondents ( 25 , 27 , 37 , 39 ); two studies included only newborns who were recipients of intravenous (IV) fluids for at least 48 h, based on the purpose of the study, in order to enroll infants most likely to have serial serum creatinine (SCR) and urine output (UOP) measurements ( 29 , 35 ); two studies made different requirements for gestational age or birth weight ( 34 , 42 ); and the other eight studies included all eligible newborns without other requirements for gestational age or birth weight ( 18 , 26 , 28 , 30 – 32 , 40 , 43 ).…”

Section: Resultsmentioning

confidence: 99%

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Risk factors for length of NICU stay of newborns: A systematic review

Song

et al. 2023

Front. Pediatr.

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BackgroundThe improvement in survival of preterm infants is accompanied by an increase in neonatal intensive care unit (NICU) admissions. Prolonged length of stay in the NICU (LOS-NICU) increases the incidence of neonatal complications and even mortality and places a significant economic burden on families and strain on healthcare systems. This review aims to identify risk factors influencing LOS-NICU of newborns and to provide a basis for interventions to shorten LOS-NICU and avoid prolonged LOS-NICU.MethodsA systematic literature search was conducted in PubMed, Web of Science, Embase, and Cochrane library for studies that were published in English from January 1994 to October 2022. The PRISMA guidelines were followed in all phases of this systematic review. The Quality in Prognostic Studies (QUIPS) tool was used to assess methodological quality.ResultsTwenty-three studies were included, 5 of which were of high quality and 18 of moderate quality, with no low-quality literature. The studies reported 58 possible risk factors in six broad categories (inherent factors; antenatal treatment and maternal factors; diseases and adverse conditions of the newborn; treatment of the newborn; clinical scores and laboratory indicators; organizational factors).ConclusionsWe identified several of the most critical risk factors affecting LOS-NICU, including birth weight, gestational age, sepsis, necrotizing enterocolitis, bronchopulmonary dysplasia, and retinopathy of prematurity. As only a few high-quality studies are available at present, well-designed and more extensive prospective studies investigating the risk factors affecting LOS-NICU are still needed in the future.

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“…The medical level of NICU may impact the results of our research. In our previous study, we found that higher NT-proBNP7 levels were associated with longer hospitalization, ROP was also one of the reasons for the long hospitalization [27]. In addition, we found the level of NT-proBNP7 can be used as an early promising biomarker for very low birth weight infants to develop moderate-to-severe BPD/death [28].…”

Section: Discussionmentioning

confidence: 99%

A good study about early predictive biomarkers in severe retinopathy of prematurity

Luo

Shi

et al. 2022

Preprint

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Objective To explore the evaluation value of N-terminal pro-brain natriuretic peptide (NT-proBNP) and cytokines in predicting severe and therapeutic retinopathy of prematurity (ROP).MethodsPremature infants from January 2020 to January 2022 were enrolled in this single-center retrospective study. General characteristics, seven cytokines within 24 hours and NT-proBNP on the 1st, 3rd, 7th and 14th days after birth were collected. Evaluated these risk factors by using univariate Logistic regression and multivariable logistic regression. Receiver operating characteristic curve analysis was used to evaluate the prediction ability. The outcome measures were the occurrence of any stage ROP, severe ROP and therapeutic ROP.Results528 premature infants were involved, 21.4% premature infants (113/528) were diagnosed with ROP, 35.4% (40/113) were diagnosed with severe ROP, 65% (26/40) received intravitreal anti-vascular endothelial growth factor treatment. After adjusting confounding factors, NT-proBNP at day 7 of life (NT-proBNP7) and IL-6 still remained significantly associated with ROP (P < 0.05). For severe ROP, the cut off values for IL-6 and NT-ProBNP7 were respectively 16.28 pg/mL (AUC = 0.830) and 2553ng/L (AUC = 0.846). The AUC value for combining the two indices was 0.919. For therapeutic ROP, the cut off values for IL-6 and NT-ProBNP7 were respectively 18.08 pg/mL (AUC = 0.845) and 4699ng/L (AUC = 0.829). The AUC value for combining the two indices was 0.915.ConclusionsNT-proBNP 7 and IL-6 can be used as early biomarkers for severe and therapeutic ROP. More importantly, two indicators have significantly higher efficacy than individual indicators.

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Association Between NT-proBNP and Prolonged Length of Stay in Hospital Among Preterm Infants Born at 28–31 Weeks' Gestation

Cited by 5 publications

References 32 publications

NT‐proBNP and Zlog‐transformed NT‐proBNP values predict extubation failure in critically ill neonates with pulmonary hypertension and ventricular dysfunction

NT‐proBNP and Zlog‐transformed NT‐proBNP values predict extubation failure in critically ill neonates with pulmonary hypertension and ventricular dysfunction

Risk factors for length of NICU stay of newborns: A systematic review

A good study about early predictive biomarkers in severe retinopathy of prematurity

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