Prognostic role of BNP in children undergoing surgery for congenital heart disease: analysis of prediction models incorporating standard risk factors

Cantinotti, Massimiliano; Giordano, Raffaele; Scalese, Marco; Molinaro, Sabrina; Pina, Francesca Della; Storti, Simona; Arcieri, Luigi; Murzi, Bruno; Marotta, Marco; Pak, Vitali; Poli, Vincenzo; Iervasi, Giorgio; Kutty, Shelby; Clerico, Aldo

doi:10.1515/cclm-2014-1084

Cited by 30 publications

(28 citation statements)

References 21 publications

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“…Various studies have shown that post-operative BNP, lack of decrease in BNP post-operatively were all strongly related to poor hemodynamics or adverse outcomes after a cardiac surgery[18,19]. Bobik et al[20] evaluated the value of NT-pro BNP in patients with atrioventricular septal defects (AVSD) preoperatively.…”

Section: B-type Natriuretic Peptide and N-terminal Segment Of Pro-b-tmentioning

confidence: 99%

Cardiac biomarkers in pediatric heart disease: A state of art review

Fernandes¹,

Maher²,

Deshpande³

2016

WJC

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Every year there are more than 11000 hospitalizations related to heart failure in children resulting in significant morbidity and mortality. Over the last two decades, our understanding, diagnosis and management of pediatric heart failure is evolving but our ability to prognosticate outcomes in pediatric heart acute heart failure is extremely limited due to lack of data. In adult heart failure patients, the role of cardiac biomarkers has exponentially increased over the last two decades. Current guidelines for management of heart failure emphasize the role of cardiac biomarkers in diagnosis, management and prognostication of heart failure. It is also noteworthy that these biomarkers reflect important biological processes that also open up the possibility of therapeutic targets. There is however, a significant gap present in the pediatric population with regards to biomarkers in pediatric heart failure. Here, we seek to review available data regarding cardiac biomarkers in the pediatric population and also explore some of the emerging biomarkers from adult literature that may be pertinent to pediatric heart failure.

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Section: B-type Natriuretic Peptide and N-terminal Segment Of Pro-b-tmentioning

confidence: 99%

Cardiac biomarkers in pediatric heart disease: A state of art review

Fernandes¹,

Maher²,

Deshpande³

2016

WJC

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“…There are sufficient evidences on the prognostic role of BNP-NT-proBNP in children undergoing cardiac surgery. [71][72][73][74][75][76][77][78][79][80][81][82][83][84][85][86][87][88][89][90] As reported by multiple authors. BNP levels (especially those measured preoperatively) were independently associated with important parameters of outcome, including the duration of mechanical ventilation, intensive care unit stay, need for inotropic support, and low cardiac output syndrome.…”

Section: Bnp In Children Undergoing Cardiac Surgery For Correction/pamentioning

confidence: 80%

“…This opposite pattern of BNP kinetics after surgery is probably the result of multiple factors including: the higher severity of CHD with neonatal presentation, the complexity of neonatal surgical procedures. 90 In addition, the maturational variations in BNP response during the first weeks of life need also to be taken into account. 69,70 Usually biomarker values tend to progressively decrease after the initial peak reached within the first 24 hours postsurgery.…”

Section: Bnp In Children Undergoing Cardiac Surgery For Correction/pamentioning

confidence: 99%

“…[3][4][5][6]112 Criteria to evaluate the clinical utility of a biomarker (including calibration, discrimination, and reclassification tests) have been recently revised [113][114][115] and only a few of the studies performed so far have respected these requirements. 90 On the whole, pediatric clinical studies on BNP are only a very small portion of the total number (< 10%) of scientific literature of this cardiac biomarker. A series of factors may condition and limit clinical research in pediatric age, especially in neonates.…”

Section: Limitations Of Current Researchmentioning

confidence: 99%

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B-Type Cardiac Natriuretic Peptides in the Neonatal and Pediatric Intensive Care Units

Cantinotti

2016

J Pediatr Intensive Care

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During the last decade, interest in the brain natriuretic peptide (BNP) and N-terminal probrain natriuretic peptide (NT-proBNP) in the pediatric population has progressively increased. The aim of this article is to provide an up to date review of evidences regarding the use of BNP/NT-proBNP in pediatrics, with a particular focus on neonatal intensive care and congenital heart disease. The potentialities of the BNP have been demonstrated in multiple settings, particularly: the screening of congenital/acquired heart disease (CHD) versus pulmonary disease; the evaluation of CHD severity (grade of heart failure, degree of left-to-right shunts); the management of children undergoing cardiac surgery; and monitoring premature infants with patent arterial duct. BNP/NT-proBNP values may be considered an easy and relatively low cost additional diagnostic and prognostic tool. Interpretation of BNP values in children requires attention to important factors, including: laboratory methods, the type of cardiac defect, its severity, and the presence of extracardiac conditions. Of these, the hemodynamic characteristic of CHD and physiologic variations of BNP values occurring during the first weeks of life play a major role. The current evidences in favor of BNP use are mainly derived from single-center, nonrandomized studies, and cost-effectiveness analysis are still lacking. As such, despite sufficient evidences supporting the diagnostic and prognostic potentialities of BNP, these findings should be reinforced by multicenter, randomized studies specifically designed to evaluate outcomes and cost-effectiveness. In addition, standard consensus documents/guidelines, that are currently lacking, are warranted for a more systematic use of BNP in the pediatric age.

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“…Some authors (16,17) use biomarkers as brain natriuretic peptide or Troponin I that may improve the risk prediction in pediatric cardiac surgery, supporting its routine use in this setting.…”

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confidence: 99%