Application of NT-proBNP in ventilator weaning for preterm infants with RDS

Summary Objective To evaluate the value of N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP) levels along with spontaneous breathing trial (SBT) in the prediction of ventilator weaning outcome among respiratory distress syndrome (RDS) preterm infants ready to wean. Methods NT‐proBNP along with plasma albumin concentration, serum sodium, serum potassium, and hematocrit were measured immediately before SBT in preterm infants (≤32 weeks) mechanically ventilated due to RDS. Extubation was considered successful if infants remained extubated >48 hr. Either SBT failure or extubation failure was considered weaning failure. Results Sixty‐three of 88 infants passed the SBT and were subsequently extubated. Of these, two (3.2%) cases rapidly developed laryngeal dyspnea imposing reintubation (excluded from analysis). Of the remaining 61 infants, 45 (73.8%) cases had successful extubation, and 16 (26.2%) cases were reintubated. Infants who failed weaning had lower gestational age, birth weight, and plasma albumin concentrations, higher NT‐proBNP, doses of surfactant, occurrence of ventilator‐associated pneumonia, and occurrence of pulmonary arterial hypertension than those who did not. NT‐proBNP was the only independent factor that could predict weaning failure (OR = 1.872; P = 0.044). The ROC‐AUC for NT‐proBNP to predict weaning failure was 0.977 (95% CI 0.918–0.997; P