TY - JOUR
T1 - B-Type Natriuretic Peptide
T2 - Biomarker of Persistent Pulmonary Hypertension of the Newborn?
AU - Shah, Nishant
AU - Natarajan, Girija
AU - Aggarwal, Sanjeev
N1 - Publisher Copyright:
© 2015 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.
PY - 2015/5/8
Y1 - 2015/5/8
N2 - Objective We assessed the utility of plasma B-type natriuretic peptide (BNP) in infants with persistent pulmonary hypertension of the newborn (PPHN) in the prediction of inhaled nitric oxide (iNO) requirement. Methods This prospective study involved neonates (gestational age ≥ 34 weeks) with PPHN and confirmatory echocardiographic findings. Plasma BNP was assayed once within 12 hours of meeting criteria for iNO requirements and twice every 24 to 48 hours thereafter. Results Infants requiring iNO (n = 14) had higher first BNP levels compared with others (n = 5) (455.5 ± 350.6 vs. 30.1 ± 25.3 ng/dL, p < 0.003). The sensitivity, specificity, positive and negative predictive values, and 95% confidence intervals (CI) for plasma BNP greater than 30 ng/dL to predict iNO requirement were 100 (85-100), 80 (37-80), 94 (80-94), and 100 (46-100)%, respectively. Corresponding values at a cut-off plasma BNP concentration greater than 85 ng/dL were 79 (62-79), 100 (53-100), 100 (79-100), and 63 (33-63)%, respectively. Conclusion BNP had excellent sensitivity and negative predictive value for iNO requirement and above 30 ng/dl maybe a useful prognostic biomarker in PPHN.
AB - Objective We assessed the utility of plasma B-type natriuretic peptide (BNP) in infants with persistent pulmonary hypertension of the newborn (PPHN) in the prediction of inhaled nitric oxide (iNO) requirement. Methods This prospective study involved neonates (gestational age ≥ 34 weeks) with PPHN and confirmatory echocardiographic findings. Plasma BNP was assayed once within 12 hours of meeting criteria for iNO requirements and twice every 24 to 48 hours thereafter. Results Infants requiring iNO (n = 14) had higher first BNP levels compared with others (n = 5) (455.5 ± 350.6 vs. 30.1 ± 25.3 ng/dL, p < 0.003). The sensitivity, specificity, positive and negative predictive values, and 95% confidence intervals (CI) for plasma BNP greater than 30 ng/dL to predict iNO requirement were 100 (85-100), 80 (37-80), 94 (80-94), and 100 (46-100)%, respectively. Corresponding values at a cut-off plasma BNP concentration greater than 85 ng/dL were 79 (62-79), 100 (53-100), 100 (79-100), and 63 (33-63)%, respectively. Conclusion BNP had excellent sensitivity and negative predictive value for iNO requirement and above 30 ng/dl maybe a useful prognostic biomarker in PPHN.
KW - B-type natriuretic peptide
KW - ECMO and outcomes
KW - persistent pulmonary hypertension of the newborn
UR - http://www.scopus.com/inward/record.url?scp=84941558046&partnerID=8YFLogxK
U2 - 10.1055/s-0035-1548540
DO - 10.1055/s-0035-1548540
M3 - Article
C2 - 26368790
AN - SCOPUS:84941558046
VL - 32
SP - 1045
EP - 1049
JO - American Journal of Perinatology
JF - American Journal of Perinatology
SN - 0735-1631
IS - 11
ER -