Amino-terminal pro-brain-type natriuretic peptide: heart or lung disease in pediatric respiratory distress?

Objectives: The aim of this study was to determine whether plasma levels of amino-terminal pro-brain natriuretic peptide (N-BNP) could differentiate between heart failure and lung disease among infants with acute respiratory distress. In addition, our aim was to determine whether plasma levels of N-BNP could be used to monitor the effects of treatment among infants with heart failure.
Methods: Infants (age range: 1-36 months; median age: 10 months) who presented with respiratory distress underwent physical examination, plasma N-BNP measurement, and echocardiography within 24 hours after admission. Seventeen infants were finally diagnosed with acute heart failure and 18 with acute lung disease. Thirteen healthy infants served as a control group.
Results: Plasma N-BNP levels were significantly higher for the infants with heart failure (median: 18452 pg/mL; range: 5375-99700 pg/mL) than for the infants with lung disease (median: 311 pg/mL; range: 76-1341 pg/mL). Among the infants with heart failure, there was a significant difference in plasma N-BNP levels before and after congestive heart failure treatment.
Conclusion: Among infants with respiratory distress, plasma N-BNP measurements can differentiate between acute heart failure and lung disease and can be used to monitor the effects of treatment for infants with heart failure.