Levels of N-terminal-pro-brain natriuretic peptide in congenital heart disease surgery and its value as a predictive biomarker

Abstract

NT-ProBNP concentration is dependent on time during the perioperative period, it peaks at 24 hours and depends on the preoperative value and CPB length. A high peptide level before surgery is an independent predictor of prolonged stay in intensive pediatric care.

Preoperative NT-proBNP values in patients with atrioventricular septal defect and its role as a predictor of early postoperative course

“…Higher incidence of infections in the complete form may be caused by prolonged ICU stay and other factors mentioned above. In the study of Pérez-Piaya et al (6), preoperative levels of NT-proBNP correlated positively with the length of cardio-pulmonary bypass and length of stay in the critical care unit. According to these authors, the peptide levels may refl ect the severity of the lesion, complexity and duration of the surgical procedure with myocardial injury and impaired cardiovascular function, and subsequently to slower recovery.…”

“…There are data available demonstrating strong correlation of NT-proBNP to right ventricular dilation and pulmonary pressure caused by left-to-right shunts (5). Together with BNP, NT-proBNP is a predictive biomarker in congenital heart disease surgery and considered an independent predictor of prolonged stay in intensive pediatric care (6).…”

Clinical utility of B‐type natriuretic peptide (NP) in pediatric cardiac surgery – a systematic review

“…Another paper published after our original search, fulfilled our inclusion criteria . From these 39 papers , we excluded a further nineteen papers which looked at long‐term postoperative outcome as these studies did not evaluate NP levels during the immediate postoperative period but rather at the time of follow‐up . This systematic review therefore includes 20 peer‐reviewed papers (Figure ).…”

“…Twelve studies, comprising a total of 596 patients, reported on the predictive value of postoperative NPs and early postoperative outcome . Peak postoperative NP levels were predictive of duration of cardiopulmonary bypass, duration of mechanical ventilation, length of stay in the intensive care unit, serum lactate, inotropic use and presence of low cardiac output syndrome as well as death and unplanned surgical intervention.…”

Changes in NT-proBNP in Young Children With Congenital Heart Malformations

“…Nevo et al, 16 used an electrochemiluminescence immunoassay to measureNT-proBNP levels in children with noncardiac disease (292 pg/mL, n=138) and compared those results to healthy children (109 pg/mL, n=59) and patients with acute cardiac disease (50 pg/mL, n=30). Perez-Piaya et al, 17 High serum NT-pro BNP levels can be used for risk stratification in heart disease, along with systemic diseases such as thalassemia, cystic fibrosis, and sepsis. 19 Recent studies have revealed that plasma BNP levels are increased in children with heart disease before treatment, and are useful for monitoring the effectiveness of treatment.…”