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Clinical implication of blood levels of B-type natriuretic peptide in pediatric patients on mechanical circulatory support
- Source :
- The Annals of thoracic surgery. 81(6)
- Publication Year :
- 2005
-
Abstract
- Background B-type natriuretic peptide (BNP) is a marker of heart failure. In adult patients with heart failure, decreased BNP levels after implantation of ventricular assist devices may be indicative of recovery. However, BNP levels among pediatric patients receiving mechanical support are largely unknown. Methods Fifteen pediatric patients with cardiogenic shock who were supported by extracorporeal membrane oxygenation (ECMO) were evaluated. The BNP levels were determined before ECMO initiation, during ECMO support, and after ECMO removal. Results All patients had elevated BNP levels before initiation of ECMO (median, 1,430 pg/mL; range, 361 to 5,000 pg/mL). Among the 15 patients, 1 received heart transplantation. Extracorporeal membrane oxygenation was withdrawn in 2 patients, and the other 12 patients were weaned from ECMO. Four patients died after initially successful weaning from ECMO. The BNP levels of the nonsurvivors (median, 3,685 pg/mL; range, 2,494 to 5,000 pg/mL) were higher than those of the survivors (median, 1,127pg/mL; range, 108 to 3,030 pg/mL) on the next few days after ECMO removal ( p = 0.016). The BNP levels on the fourth day after removal of ECMO among the survivors (median, 498 pg/mL; range, 108 to 890 pg/mL) were lower than those among the nonsurvivors (median, 3,900 pg/mL; range, 3,230 to 5,000 pg/mL; p = 0.017). Conclusions Among pediatric patients supported with ECMO, the survivors had lower BNP levels than those who did not survive. We suggest that serial blood BNP levels can be potential markers for monitoring pediatric patients on mechanical circulatory support, and the concept merits further study.
- Subjects :
- Pulmonary and Respiratory Medicine
Thorax
Male
Critical Care
medicine.drug_class
medicine.medical_treatment
Cardiac Output, Low
Shock, Cardiogenic
Cohort Studies
Extracorporeal Membrane Oxygenation
Postoperative Complications
Predictive Value of Tests
Natriuretic Peptide, Brain
Natriuretic peptide
medicine
Extracorporeal membrane oxygenation
Humans
Prospective Studies
Child
Heart transplantation
Cardiopulmonary Bypass
business.industry
Cardiogenic shock
Infant, Newborn
Infant
medicine.disease
Brain natriuretic peptide
Prognosis
Survival Analysis
Heart Arrest
surgical procedures, operative
Treatment Outcome
Anesthesia
Heart failure
Child, Preschool
Circulatory system
Surgery
Female
Cardiology and Cardiovascular Medicine
business
Biomarkers
Subjects
Details
- ISSN :
- 15526259
- Volume :
- 81
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- The Annals of thoracic surgery
- Accession number :
- edsair.doi.dedup.....296544a086a1089bd90e656a8105198a