Role of NT‐proBNP in the prediction of moderate to severe Bronchopulmonary Dysplasia in preterm infants

Khan, Safdar S.; Concina, Vanessa A.; Schneider, D; Westgate, Philip M.; Arriagada, Susana; Bada, Henrietta S.

doi:10.1002/ppul.24610

Cited by 15 publications

(24 citation statements)

References 32 publications

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“…In another small study ( n = 51) of GA <30 weeks, Harris et al ( 12 ) found that the level of NT-proBNP at 10 days after birth was valuable in predicting severe BPD. Additionally, Khan et al ( 13 ) showed that the NT-proBNP levels on the 28th day after birth were moderately predictive of the severity of BPD in a prospective study. These studies all measured the NT-proBNP levels on a particular day, but the postnatal NT-proBNP levels in newborns are a dynamic process.…”

Section: Introductionmentioning

confidence: 99%

Development of a Nomogram for Moderate-to-Severe Bronchopulmonary Dysplasia or Death: Role of N-Terminal Pro-brain Natriuretic Peptide as a Biomarker

et al. 2021

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Objectives: This study aimed to explore the clinical value of N-terminal pro-brain natriuretic peptide (NT-proBNP) in predicting moderate-to-severe bronchopulmonary dysplasia (BPD)/death, and to establish an effective clinical predictive nomogram.Methods: We retrospectively analyzed very low birth weight infants (VLBWs) with gestational age ≤ 32 weeks. The NT-proBNP values were determined on the 1st, 3rd, 7th, 14th, 21st, and 28th days after birth. The correlation between NT-proBNP level and moderate-to-severe BPD/death was evaluated. Receiver operating characteristic (ROC) curve analysis was used to evaluate the prediction ability. Then, we used multivariable logistic regression to build the prediction model and nomogram, and calibration of the model was assessed by calibration curve.Results: In total, 556 VLBWs were involved, among whom 229 developed BPD (mild: n = 109; moderate: n = 68; severe: n = 52) and 18 died. The NT-proBNP level in the moderate-to-severe BPD/death group was significantly higher than that in the no-to-mild BPD group from the 3rd to 28th day (P < 0.001). When the natural logarithm of the serum NT-ProBNP level increased by 1 unit at day 7 (±2 days) of life, the risk of moderate and severe BPD/death was the highest (OR = 3.753; 95% CI: 2.984~4.720), and ROC analysis identified an optimal cutoff point of 3360 ng/L (sensitivity: 80.0%; specificity: 86.2%; AUC: 0.861). After adjusting for confounding factors, the level of NT-proBNP at day 7 (±2 days) of life still had important predictive value for the development of moderate-to-severe BPD/death, significantly improving the predictive ability of the model.Conclusion: The level of NT-proBNP at day 7 (±2 days) of life can be used as an early promising biomarker for VLBWs to develop moderate-to-severe BPD/death. We constructed an early predictive nomogram to help clinicians identify high-risk populations.

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Section: Introductionmentioning

confidence: 99%

Development of a Nomogram for Moderate-to-Severe Bronchopulmonary Dysplasia or Death: Role of N-Terminal Pro-brain Natriuretic Peptide as a Biomarker

et al. 2021

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“…We have previously reported the clinical utility of serum NT-proBNP on day 28 of life to predict moderate to severe BPD. 15 In that study, infants who later developed moderate to severe BPD had higher NT-proBNP levels. Therefore, in addition to the diagnostic value for a cardiopulmonary pathology, we believe that following the NT-proBNP trend may have clinical utility in monitoring disease progression in these infants.…”

Section: Discussionmentioning

confidence: 82%

“…Therefore, an upward trend of NT-proBNP beyond the neonatal period may warrant further investigation and monitoring of secondary pulmonary hypertension in those infants. We have previously reported the clinical utility of serum NT-proBNP on day 28 of life to predict moderate to severe BPD 15 . In that study, infants who later developed moderate to severe BPD had higher NT-proBNP levels.…”

Section: More Recently Fritz Et Al Determined Serum Nt-probnp Values Of 118 Preterm Infants Born ≤ 31mentioning

confidence: 99%

“…Several studies have also reported the clinical utility of NT-proBNP for infants with patent ductus arteriosus (PDA) [9][10][11][12] , bronchopulmonary disease (BPD) [13][14][15][16][17][18][19][20][21][22][23] , and secondary pulmonary…”

Section: Introductionmentioning

confidence: 99%

“…5 In addition, NT-proBNP can be used to monitor disease progression and treatment response among infants with heart failure. [6][7][8] Several studies have also reported the clinical utility of NT-proBNP for infants with patent ductus arteriosus (PDA), [9][10][11][12] bronchopulmonary disease (BPD), [13][14][15][16][17][18][19][20][21][22][23] and secondary pulmonary hypertension. 16,23 Because of the preference for a blood sparing and noninvasive approach for premature infants, many investigators have used urine instead of serum NT-proBNP as a biomarker in these infants.…”

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The Trend of Urinary N Terminal Probrain Natriuretic Peptide in Extremely Low Birth Weight Infants during the Neonatal Period

et al. 2021

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Background: NT-proBNP is a biomarker of interest in many cardiopulmonary diseases in extremely low birth weight (ELBW) Infants. However, there is a gap in knowledge about the trend of ELBW infant’s urinary NT-proBNP during the neonatal period. Aim: To determine the trend of urinary NT-proBNP during the first four weeks of life of an ELBW infant Study Design: We analyzed prospectively enrolled, 87 ELBW infants. Urinary NT-proBNP to creatinine ratios were measured on days 1-7, day 14, and day 28 of life. In addition, we plotted each study point's means to determine the trend of urinary NT-proBNP over the entire neonatal period. Data were analyzed using the Friedman ANOVA for comparative analysis of study points. Results: Urinary NT-proBNP/creatinine ratios were significantly elevated on days 1-7 (mean 2452, + 1518) than day 14 (mean 747, +176), and day 28 (mean149, +54), p=0.001. Overall, urinary NT-proBNP levels were highest during the days 1-3 (mean 3232+1255) and lowest on day 28 (mean149, +54). Conclusions: Urinary NT-proBNP levels are higher during the first week in ELBW infants with a downward trend during the neonatal period, with the lowest values at four weeks postnatal age. More studies are required to determine the clinical utility of this trend during and beyond the neonatal period.

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Current diagnosis and treatment practice for pulmonary hypertension in bronchopulmonary dysplasia—A survey study in Germany (PUsH BPD)

Häfner,

Johansson,

Schwarzkopf

et al. 2023

Pulm. circ.

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Pulmonary hypertension (PH) is the most severe complication in preterm infants with bronchopulmonary dysplasia (BPD) and associated with significant mortality. Diagnostic and treatment strategies, however, still lack standardization. By the use of a survey study (PH in BPD), we assessed clinical practice (diagnosis, treatment, follow‐up) in preterm infants with early postnatal persistent pulmonary hypertension of the newborn (PPHN) as well as at risk for or with established BPD‐associated PH between 06/2018 and 10/2020 in two‐thirds of all German perinatal centers with >70 very low birthweight infants/year including their cardiology departments and outpatient units. Data were analyzed descriptively by measures of locations and distributional shares. In routine postnatal care, clinical presentation and echocardiography were reported as the main diagnostic modalities to screen for PPHN in preterm infants, whereas biomarkers brain natriuretic peptide/N‐terminal pro b‐type natriuretic peptide were infrequently used. For PPHN treatment, inhaled nitric oxide was used in varying frequency. The majority of participants agreed to prescribe diuretics and steroids (systemic/inhaled) for infants at risk for or with established BPD‐associated PH and strongly agreed on recommending respiratory syncytial virus immunization and the use of home monitoring upon discharge. Reported oxygen saturation targets, however, varied in these patients in in‐ and outpatient care. The survey reveals shared practices in diagnostic and therapeutic strategies for preterms with PPHN and BPD‐associated PH in Germany. Future studies are needed to agree on detailed echo parameters and biomarkers to diagnose and monitor disease next to a much‐needed agreement on the use of pulmonary vasodilators, steroids, and diuretics as well as target oxygen saturation levels.

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Role of NT‐proBNP in the prediction of moderate to severe Bronchopulmonary Dysplasia in preterm infants

Cited by 15 publications

References 32 publications

Development of a Nomogram for Moderate-to-Severe Bronchopulmonary Dysplasia or Death: Role of N-Terminal Pro-brain Natriuretic Peptide as a Biomarker

Development of a Nomogram for Moderate-to-Severe Bronchopulmonary Dysplasia or Death: Role of N-Terminal Pro-brain Natriuretic Peptide as a Biomarker

The Trend of Urinary N Terminal Probrain Natriuretic Peptide in Extremely Low Birth Weight Infants during the Neonatal Period

Current diagnosis and treatment practice for pulmonary hypertension in bronchopulmonary dysplasia—A survey study in Germany (PUsH BPD)

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