B‐type natriuretic peptide monitoring in the Pediatric ICU population

Abstract

The natriuretic peptide system plays an active role in the regulation of fluid balance and systemic vascular resistance. Assays of these peptides are now available and may be used for both diagnostic and prognostic purposes. Despite its primary use in adults, it may have a diagnostic role in the Pediatric ICU as well. The basic physiology of the natriuretic system is discussed and the potential applications of B-type natriuretic peptide (BNP) monitoring as a diagnostic tool in various clinical scenarios in infants and children in the Pediatric ICU setting is reviewed.

B-type Natriuretic Peptide: Perioperative Patterns in Congenital Heart Disease

“…The recent availability of point‐of‐care BNP assays and therapeutic BNP (nesiritide) has stimulated a great deal of contemporary research. Several reviews have recently been undertaken in pediatrics that acknowledge that perturbations of the natriuretic hormone system are common in the settings of critical illness and congenital heart disease (CHD) but assert that further investigation is needed before this measure is of practical utility in these populations 10–16 …”

“…Several reviews have recently been undertaken in pediatrics that acknowledge that perturbations of the natriuretic hormone system are common in the settings of critical illness and congenital heart disease (CHD) but assert that further investigation is needed before this measure is of practical utility in these populations. [10][11][12][13][14][15][16] As a therapeutic agent, human recombinant BNP (hrBNP) has been used to treat adults and children with decompensated CHF, demonstrating some improvements in cardiac performance. [17][18][19] While garnering early enthusiasm, several studies subsequent to Food and Drug Administration approval have questioned the safety of therapeutic hrBNP, noting possible increased risks of renal dysfunction and mortality.…”