Can early b-type natriuretic peptide assays predict symptomatic patent ductus arteriosus in extremely low birth weight infants?

Jang Hoon Lee, Jeong Hee Shin, Kyu Hee Park, Young-Jun Rhie, Moon Sung Park, Byung Min Choi

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Background: Earlier and more accurate identification of a high-risk group of preterm infants that are likely to develop a hemodynamically significant patent ductus arteriosus (hsPDA) would allow specific targeting of early treatment and thus possibly minimize the morbidity and mortality associated with a PDA in extremely low birth weight (ELBW) infants. Objective: To investigate the predictability of B-type natriuretic peptide (BNP) for early targeted treatment of hsPDA in ELBW infants. Methods: 73 ELBW infants that underwent echocardiographic evaluation and plasma BNP measurement after birth were enrolled. 31 infants developed hsPDA (HsPDA group) and 42 infants did not develop hsPDA (nPDA group). Results: BNP levels of the HsPDA group were significantly higher than those of the nPDA group at 24 h of age (921 [318-2,133] vs. 152 [91-450] pg/ml) but not different at 12 h of age. BNP levels at 24 h of age were significantly correlated with the magnitudes of the ductal shunt but not at 12 h of age. The area under the receiver operator characteristic curve of BNP levels for prediction of hsPDA at 24 h of age was 0.830. At the cutoff BNP levels of 200 and 900 pg/ml at 24 h of age, sensitivity was 83.9 and 54.8% and specificity was 61.9 and 95.2%, respectively. Conclusions: BNP levels at 24 h of age can be used as a guide for early targeted treatment of hsPDA and avoid the unnecessary use of cyclooxygenase inhibitors in ELBW infants.

Original languageEnglish
Pages (from-to)118-122
Number of pages5
JournalNeonatology
Volume103
Issue number2
DOIs
Publication statusPublished - 2013 Jan 1

Fingerprint

Extremely Low Birth Weight Infant
Natriuretic Peptides
Patent Ductus Arteriosus
Brain Natriuretic Peptide
Cyclooxygenase Inhibitors
Premature Infants
Therapeutics
Parturition
Morbidity
Mortality

Keywords

  • B-type natriuretic peptide
  • Patent ductus arteriosus
  • Predictable usefulness
  • Preterm infant

ASJC Scopus subject areas

  • Developmental Biology
  • Pediatrics, Perinatology, and Child Health

Cite this

Can early b-type natriuretic peptide assays predict symptomatic patent ductus arteriosus in extremely low birth weight infants? / Lee, Jang Hoon; Shin, Jeong Hee; Park, Kyu Hee; Rhie, Young-Jun; Park, Moon Sung; Choi, Byung Min.

In: Neonatology, Vol. 103, No. 2, 01.01.2013, p. 118-122.

Research output: Contribution to journalArticle

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abstract = "Background: Earlier and more accurate identification of a high-risk group of preterm infants that are likely to develop a hemodynamically significant patent ductus arteriosus (hsPDA) would allow specific targeting of early treatment and thus possibly minimize the morbidity and mortality associated with a PDA in extremely low birth weight (ELBW) infants. Objective: To investigate the predictability of B-type natriuretic peptide (BNP) for early targeted treatment of hsPDA in ELBW infants. Methods: 73 ELBW infants that underwent echocardiographic evaluation and plasma BNP measurement after birth were enrolled. 31 infants developed hsPDA (HsPDA group) and 42 infants did not develop hsPDA (nPDA group). Results: BNP levels of the HsPDA group were significantly higher than those of the nPDA group at 24 h of age (921 [318-2,133] vs. 152 [91-450] pg/ml) but not different at 12 h of age. BNP levels at 24 h of age were significantly correlated with the magnitudes of the ductal shunt but not at 12 h of age. The area under the receiver operator characteristic curve of BNP levels for prediction of hsPDA at 24 h of age was 0.830. At the cutoff BNP levels of 200 and 900 pg/ml at 24 h of age, sensitivity was 83.9 and 54.8{\%} and specificity was 61.9 and 95.2{\%}, respectively. Conclusions: BNP levels at 24 h of age can be used as a guide for early targeted treatment of hsPDA and avoid the unnecessary use of cyclooxygenase inhibitors in ELBW infants.",
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