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N-terminal B-type natriuretic peptide levels in pediatric patients with congestive heart failure undergoing cardiac surgery.
J Thorac Cardiovasc Surg. 2008 Jan; 135(1):98-105.JT

Abstract

OBJECTIVES

The objectives of this study were to measure circulating N-terminal B-type natriuretic peptide levels in pediatric patients undergoing surgical repair of congenital heart lesions with left ventricular volume overload and to determine whether presurgical and immediate postoperative N-terminal B-type natriuretic peptide levels could predict patient outcomes after surgical intervention.

METHODS

Thirty-eight children aged 1 to 36 months undergoing surgical repair of cardiac lesions with left ventricular volume overload were studied. Plasma N-terminal B-type natriuretic peptide levels were measured preoperatively and at 2, 12, 24, 48, and 72 hours after surgical intervention and were assessed for their predictive value of postoperative outcomes. Plasma N-terminal B-type natriuretic peptide levels were also measured in 34 similarly aged healthy children.

RESULTS

Patient preoperative N-terminal B-type natriuretic peptide levels were significantly higher than those of healthy control subjects (3085 +/- 4046 vs 105 +/- 78 pg/mL). Preoperative N-terminal B-type natriuretic peptide levels correlated with the complexity of surgical repair, as measured by cardiopulmonary bypass time (r = 0.529, P < .001), and with postoperative measures, including fractional inhaled oxygen requirements registered at 12 hours (r = 0.443, P = .005) and duration of mechanical ventilation (r = 0.445, P = .005). Plasma N-terminal B-type natriuretic peptide levels increased 5-fold within 12 hours after cardiopulmonary bypass (14,685 +/- 14,317 pg/mL). Multivariable regression analysis showed that the preoperative N-terminal B-type natriuretic peptide level was a significant predictor of duration of intensive care unit stay (P = .02) and that the peak postoperative N-terminal B-type natriuretic peptide level was a significant predictor of the intensity of overall medical management, as assessed by using the therapeutic intervention scoring system (P = .01).

CONCLUSION

Plasma N-terminal B-type natriuretic peptide levels measured preoperatively and postoperatively can be a prognostic indicator in the management of the pediatric patient after surgical intervention for congenital heart repair.

Authors+Show Affiliations

Division of Pediatric Cardiology, Department of Pediatrics, Schneider Children's Hospital, New Hyde Park, New York, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18179925

Citation

Walsh, Rowan, et al. "N-terminal B-type Natriuretic Peptide Levels in Pediatric Patients With Congestive Heart Failure Undergoing Cardiac Surgery." The Journal of Thoracic and Cardiovascular Surgery, vol. 135, no. 1, 2008, pp. 98-105.
Walsh R, Boyer C, LaCorte J, et al. N-terminal B-type natriuretic peptide levels in pediatric patients with congestive heart failure undergoing cardiac surgery. J Thorac Cardiovasc Surg. 2008;135(1):98-105.
Walsh, R., Boyer, C., LaCorte, J., Parnell, V., Sison, C., Chowdhury, D., & Ojamaa, K. (2008). N-terminal B-type natriuretic peptide levels in pediatric patients with congestive heart failure undergoing cardiac surgery. The Journal of Thoracic and Cardiovascular Surgery, 135(1), 98-105. https://doi.org/10.1016/j.jtcvs.2007.08.012
Walsh R, et al. N-terminal B-type Natriuretic Peptide Levels in Pediatric Patients With Congestive Heart Failure Undergoing Cardiac Surgery. J Thorac Cardiovasc Surg. 2008;135(1):98-105. PubMed PMID: 18179925.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - N-terminal B-type natriuretic peptide levels in pediatric patients with congestive heart failure undergoing cardiac surgery. AU - Walsh,Rowan, AU - Boyer,Clark, AU - LaCorte,Jared, AU - Parnell,Vincent, AU - Sison,Cristina, AU - Chowdhury,Devyani, AU - Ojamaa,Kaie, PY - 2007/04/20/received PY - 2007/08/06/revised PY - 2007/08/15/accepted PY - 2008/1/9/pubmed PY - 2008/2/8/medline PY - 2008/1/9/entrez SP - 98 EP - 105 JF - The Journal of thoracic and cardiovascular surgery JO - J Thorac Cardiovasc Surg VL - 135 IS - 1 N2 - OBJECTIVES: The objectives of this study were to measure circulating N-terminal B-type natriuretic peptide levels in pediatric patients undergoing surgical repair of congenital heart lesions with left ventricular volume overload and to determine whether presurgical and immediate postoperative N-terminal B-type natriuretic peptide levels could predict patient outcomes after surgical intervention. METHODS: Thirty-eight children aged 1 to 36 months undergoing surgical repair of cardiac lesions with left ventricular volume overload were studied. Plasma N-terminal B-type natriuretic peptide levels were measured preoperatively and at 2, 12, 24, 48, and 72 hours after surgical intervention and were assessed for their predictive value of postoperative outcomes. Plasma N-terminal B-type natriuretic peptide levels were also measured in 34 similarly aged healthy children. RESULTS: Patient preoperative N-terminal B-type natriuretic peptide levels were significantly higher than those of healthy control subjects (3085 +/- 4046 vs 105 +/- 78 pg/mL). Preoperative N-terminal B-type natriuretic peptide levels correlated with the complexity of surgical repair, as measured by cardiopulmonary bypass time (r = 0.529, P < .001), and with postoperative measures, including fractional inhaled oxygen requirements registered at 12 hours (r = 0.443, P = .005) and duration of mechanical ventilation (r = 0.445, P = .005). Plasma N-terminal B-type natriuretic peptide levels increased 5-fold within 12 hours after cardiopulmonary bypass (14,685 +/- 14,317 pg/mL). Multivariable regression analysis showed that the preoperative N-terminal B-type natriuretic peptide level was a significant predictor of duration of intensive care unit stay (P = .02) and that the peak postoperative N-terminal B-type natriuretic peptide level was a significant predictor of the intensity of overall medical management, as assessed by using the therapeutic intervention scoring system (P = .01). CONCLUSION: Plasma N-terminal B-type natriuretic peptide levels measured preoperatively and postoperatively can be a prognostic indicator in the management of the pediatric patient after surgical intervention for congenital heart repair. SN - 1097-685X UR - https://www.unboundmedicine.com/medline/citation/18179925/N_terminal_B_type_natriuretic_peptide_levels_in_pediatric_patients_with_congestive_heart_failure_undergoing_cardiac_surgery_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-5223(07)01389-X DB - PRIME DP - Unbound Medicine ER -