Published online June 1, 2006
PEDIATRICS Vol. 117 No. 6 June 2006, pp. 2183-2189 (doi:10.1542/peds.2005-1387)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Web of Science (3)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by da Graca, R. L.
Right arrow Articles by Auld, P. A.M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by da Graca, R. L.
Right arrow Articles by Auld, P. A.M.
Related Collections
Right arrow Heart & Blood Vessels
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

Longitudinal Changes of Brain-Type Natriuretic Peptide in Preterm Neonates

Ralph L. da Graca, MDa,b, Denise C. Hassinger, MDa,b, Patrick A. Flynn, MDa,c, Cristina P. Sison, PhDd, Mirjana Nesin, MDa,b and Peter A.M. Auld, MDa,b

a Department of Pediatrics, New York Presbyterian Hospital, Weill Medical College of Cornell University, New York, New York
b Division of Newborn Medicine, New York Presbyterian Hospital, Weill Medical College of Cornell University, New York, New York
c Division of Pediatric Cardiology, New York Presbyterian Hospital, Weill Medical College of Cornell University, New York, New York
d Department of Statistics, North Shore-Long Island Jewish Health System, Manhasset, New York

OBJECTIVE. To determine age-related concentrations of brain-type natriuretic peptide in preterm infants using bedside Triage brain-type natriuretic peptide test and correlate it to the presence or absence of the patent ductus arteriosus and ventilatory support.

METHODS. Serum brain-type natriuretic peptide levels were measured in infants who were born at <32 weeks’ gestation from birth to 2 months of age. Serial echocardiograms were performed, until closure of the patent ductus arteriosus, or until discharge. Brain-type natriuretic peptide levels were correlated to the day of life, gestational age, presence or absence of the patent ductus arteriosus, and the degree of ventilatory support. Nineteen preterm infants (gestational age: 24–31 weeks; birth weight: 645–1670 g) were enrolled prospectively during the first 2 weeks of life. Serum brain-type natriuretic peptide levels (pg/mL) were determined in 177 blood samples, and 87 paired echocardiograms were performed.

RESULTS. Significant negative correlation was found between brain-type natriuretic peptide levels and the day of life and remained significant when the patients were stratified by gestational age (≤28 weeks and >28 weeks). Higher brain-type natriuretic peptide levels correlated with increasing grade of the patent ductus arteriosus. Significant differences in brain-type natriuretic peptide levels were seen with increasing ventilatory support. Comparisons between the size of patent ductus arteriosus and the degree of ventilatory support to brain-type natriuretic peptide levels revealed that the size of the patent ductus arteriosus was the major determinant of both brain-type natriuretic peptide levels and the degree of ventilatory support.

CONCLUSIONS. Similar to term infants, brain-type natriuretic peptide levels of preterm infants are related to the chronological age and decline during the first month of life. Rapid bedside Triage brain-type natriuretic peptide is a potentially valuable and practical assay in determining the hemodynamic changes in preterm infants.

Key Words: B-type natriuretic peptide • Triage BNP • prematurity • preterm infants • patent ductus arteriosus

Abbreviations: BNP—brain-type natriuretic peptide • N-BNP—N-terminal BNP • CHF—congestive heart failure • PDA—patent ductus arteriosus • GA—gestational age • NCPAP—nasal continuous positive airway pressure • IQR—interquartile range • DOL—day of life • RDS—respiratory distress syndrome

Accepted Dec 27, 2005.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?