Brain-Type Natriuretic Peptide in the Diagnosis and Management of Persistent Pulmonary Hypertension of the Newborn

Reynolds, E. W.; Ellington, J G; Vranicar, Mark; Bada, Henrietta S.

doi:10.1542/peds.2004-0525

Cited by 137 publications

(96 citation statements)

References 13 publications

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“…BNP levels have also been used to identify PPHN; Reynolds et al showed that an initial BNP level of >159 pmol/l has a specificity of 90% and a sensitivity of 100% in predicting PPHN. They reported (as our group also did in its study) a strong relationship between BNP and echocardiographic signs of increased pulmonary vascular resistance (69,70). With BNP and NT-proBNP being suggested as screening biomarkers, it is important to realize that congenital heart defects can also present themselves with PPHN and elevated BNP levels (71).…”

Section: Patent Ductus Arteriosussupporting

confidence: 61%

Use of cardiac biomarkers in neonatology

et al. 2012

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Section: Patent Ductus Arteriosussupporting

confidence: 61%

Use of cardiac biomarkers in neonatology

et al. 2012

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“…4,5 BNP may also be used to distinguish neonates with persistent pulmonary hypertension from those with parenchymal lung disease. 6 NTpBNP is an inactive by-product of BNP, which is more stable, and has a longer half-life. Reference ranges for NTpBNP in term neonates have been published, and its potential role in PDA diagnosis was recently demonstrated.…”

Section: Introductionmentioning

confidence: 99%

Cardiac troponin T and N-terminal-pro-B type natriuretic peptide reflect myocardial function in preterm infants

et al. 2008

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Background: Cardiovascular compromise is increasingly recognized in preterm infants. Currently, echocardiography is the best tool to assess myocardial contractility and guide management. Elevated levels of cardiac troponin T (cTnT) and N-terminal-pro-B type natriuretic peptide (NTpBNP) are associated with poor myocardial contractility and low cardiac output in adults.Objective: To examine the range of cTnT and NTpBNP in preterm infants, to correlate NTpBNP and cTnT with echocardiographic markers of cardiac function and to assess the influence of antenatal and postnatal factors on these biochemical markers.Study Design: Plasma concentrations of cTnT and NTpBNP were measured in infants <1500 g at 12 h of age. These were correlated with simultaneous echocardiographic measures of myocardial function and output. Antenatal data, infant demographics and postnatal characteristics were prospectively recorded.Result: A total of 80 infant had samples taken and echocardiography performed. Their median (interquartile range) cTnT and NTpBNP values were 0.20 mg l À1 (0.11 to 0.40) and 1273 pmol l À1 (664 to 2798), respectively. There was a significant inverse correlation between cTnT and echocardiographic markers of myocardial function and stroke volume. NTpBNP significantly correlated with left atrial to aortic root ratio (LA:Ao). There was a weaker but significant negative correlation between NTpBNP and left ventricular (LV) function. The assays were not influenced by gestation, birth weight, gender or mode of delivery.Conclusion: cTnT and NTpBNP are correlated with echocardiographic measures of cardiac performance in preterm infants. Measurement of levels in the first hours of life may provide useful information regarding myocardial function and volume loading.

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“…20 There are reports about the capability of BNP to differentiate respiratory distress syndrome from PHT in NBIs; this means that BNP measurement may tell the difference between patients with a purely respiratory condition and those with hemodynamic or cardiac compromise. 28 A strong correlation has been observed, in NBIs with PHT, among BNP, clinical severity, 29,30 and treatment response. 31 Baptista et al 32 studied BNP levels in patients with congenital diaphragmatic hernia (CDH) and observed an association among BNP levels, the severity of PHT, and mortality in this population.…”

Section: Discussionmentioning

confidence: 94%

B-type natriuretic peptide: Usefulness in the management of critically-ill neonates

et al. 2017

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B-type natriuretic peptide (BNP) is responsible for changes in the heart organogenesis and is associated with transition to extrauterine life. In the first week of life, BNP levels are high and return to normal with the physiological loss in weight. High BNP levels are associated with different conditions. Objective. To establish the relationship between BNP levels and criticality and the short-term clinical course among patients hospitalized in the neonatal intensive care unit. Method. Observational and analytical study conducted in a prospective cohort. Criticality was defined as a requirement for assisted mechanical ventilation with a fraction of inspired oxygen of more than 50% and/or inotropes. Two blood samples were collected 72 hours apart. Results. Seventy-three patients were included in the study. Depending on their clinical course on day 7, they were divided into 2 groups: patients with a good clinical course or a persistent, severe clinical course. The median baseline BNP level was similar in both groups (p: 0.15). The median BNP level at 72 hours was higher among patients with a persistent, severe clinical course (p: 0.005). The difference between both BNP values was calculated (∆BNP: BNP level at 72 hours -BNP level at 0 hours). The ∆BNP was positive among patients with a persistent, severe clinical course (X= 1260 pg/mL; range: 426-2094) and negative in the group with a good clinical course (X= -967 pg/mL; range: -1656/-278) (p: 0.0002); sensitivity: 87%; specificity: 86%; positive predictive value: 74%; and negative predictive value: 93%. Conclusion. In this group of patients, the delta-BNP value reflected the short-term clinical course.

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Brain-Type Natriuretic Peptide in the Diagnosis and Management of Persistent Pulmonary Hypertension of the Newborn

Cited by 137 publications

References 13 publications

Use of cardiac biomarkers in neonatology

Use of cardiac biomarkers in neonatology

Cardiac troponin T and N-terminal-pro-B type natriuretic peptide reflect myocardial function in preterm infants

B-type natriuretic peptide: Usefulness in the management of critically-ill neonates

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