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B-type natriuretic peptide levels predict outcome after neonatal cardiac surgery.
J Thorac Cardiovasc Surg. 2007 Oct; 134(4):939-45.JT

Abstract

OBJECTIVES

Neonates undergoing cardiac surgery are at high risk for adverse outcomes. B-type natriuretic peptide is used as a biomarker in patients with cardiac disease, but the predictive value of B-type natriuretic peptide after cardiac surgery in neonates has not been evaluated. Therefore, the objective of this study was to determine the predictive value of perioperative B-type natriuretic peptide levels for postoperative outcomes in neonates undergoing cardiac surgery.

METHODS

Plasma B-type natriuretic peptide determinations were made before and 2, 12, and 24 hours after surgery in 36 consecutive neonates. B-type natriuretic peptide levels and changes in perioperative B-type natriuretic peptide were evaluated as predictors of postoperative outcome.

RESULTS

B-type natriuretic peptide levels at 24 hours were lower than preoperative levels (24-h/pre B-type natriuretic peptide ratio < 1) in 29 patients (81%) and higher (24-h/pre B-type natriuretic peptide ratio > or = 1) in 7 patients (19%). A 24-hour/pre B-type natriuretic peptide level of 1 or greater was associated with an increased incidence of low cardiac output syndrome (100% vs 34%, P = .002) and fewer ventilator-free days (17 +/- 13 days vs 26 +/- 3 days, P = .002), and predicted the 6-month composite end point of death, an unplanned cardiac operation, or cardiac transplant (57% vs 3%, P = .003). A 24-hour/pre B-type natriuretic peptide level of 1 or greater had a sensitivity of 80% and a specificity of 90% for predicting a poor postoperative outcome (P = .003).

CONCLUSION

In neonates undergoing cardiac surgery, an increase in B-type natriuretic peptide 24 hours after surgery predicts poor postoperative outcome.

Authors+Show Affiliations

Department of Pediatrics, University of California, San Francisco, Calif, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17903511

Citation

Hsu, Jong-Hau, et al. "B-type Natriuretic Peptide Levels Predict Outcome After Neonatal Cardiac Surgery." The Journal of Thoracic and Cardiovascular Surgery, vol. 134, no. 4, 2007, pp. 939-45.
Hsu JH, Keller RL, Chikovani O, et al. B-type natriuretic peptide levels predict outcome after neonatal cardiac surgery. J Thorac Cardiovasc Surg. 2007;134(4):939-45.
Hsu, J. H., Keller, R. L., Chikovani, O., Cheng, H., Hollander, S. A., Karl, T. R., Azakie, A., Adatia, I., Oishi, P., & Fineman, J. R. (2007). B-type natriuretic peptide levels predict outcome after neonatal cardiac surgery. The Journal of Thoracic and Cardiovascular Surgery, 134(4), 939-45.
Hsu JH, et al. B-type Natriuretic Peptide Levels Predict Outcome After Neonatal Cardiac Surgery. J Thorac Cardiovasc Surg. 2007;134(4):939-45. PubMed PMID: 17903511.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - B-type natriuretic peptide levels predict outcome after neonatal cardiac surgery. AU - Hsu,Jong-Hau, AU - Keller,Roberta L, AU - Chikovani,Omar, AU - Cheng,Henry, AU - Hollander,Seth A, AU - Karl,Tom R, AU - Azakie,Anthony, AU - Adatia,Ian, AU - Oishi,Peter, AU - Fineman,Jeffrey R, PY - 2007/03/01/received PY - 2007/04/10/revised PY - 2007/04/16/accepted PY - 2007/10/2/pubmed PY - 2007/11/9/medline PY - 2007/10/2/entrez SP - 939 EP - 45 JF - The Journal of thoracic and cardiovascular surgery JO - J Thorac Cardiovasc Surg VL - 134 IS - 4 N2 - OBJECTIVES: Neonates undergoing cardiac surgery are at high risk for adverse outcomes. B-type natriuretic peptide is used as a biomarker in patients with cardiac disease, but the predictive value of B-type natriuretic peptide after cardiac surgery in neonates has not been evaluated. Therefore, the objective of this study was to determine the predictive value of perioperative B-type natriuretic peptide levels for postoperative outcomes in neonates undergoing cardiac surgery. METHODS: Plasma B-type natriuretic peptide determinations were made before and 2, 12, and 24 hours after surgery in 36 consecutive neonates. B-type natriuretic peptide levels and changes in perioperative B-type natriuretic peptide were evaluated as predictors of postoperative outcome. RESULTS: B-type natriuretic peptide levels at 24 hours were lower than preoperative levels (24-h/pre B-type natriuretic peptide ratio < 1) in 29 patients (81%) and higher (24-h/pre B-type natriuretic peptide ratio > or = 1) in 7 patients (19%). A 24-hour/pre B-type natriuretic peptide level of 1 or greater was associated with an increased incidence of low cardiac output syndrome (100% vs 34%, P = .002) and fewer ventilator-free days (17 +/- 13 days vs 26 +/- 3 days, P = .002), and predicted the 6-month composite end point of death, an unplanned cardiac operation, or cardiac transplant (57% vs 3%, P = .003). A 24-hour/pre B-type natriuretic peptide level of 1 or greater had a sensitivity of 80% and a specificity of 90% for predicting a poor postoperative outcome (P = .003). CONCLUSION: In neonates undergoing cardiac surgery, an increase in B-type natriuretic peptide 24 hours after surgery predicts poor postoperative outcome. SN - 1097-685X UR - https://www.unboundmedicine.com/medline/citation/17903511/B_type_natriuretic_peptide_levels_predict_outcome_after_neonatal_cardiac_surgery_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-5223(07)00720-9 DB - PRIME DP - Unbound Medicine ER -