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 p...
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| Veröffentlicht in: | Pediatric pulmonology 2014-08, Vol.49 (8), p.757-763 |
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| container_title | Pediatric pulmonology |
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| creator | Zhang, Qian Shi, Zan Yang Luo, Cheng Han Wang, Li Zhang, Shan Shan Cheng, Xin Ru Zhang, Qin Xu, Qian Ya Guo, Hong Xiang Cheng, Xiu Yong Sheng, Guang Yao |
| description | 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 |
| doi_str_mv | 10.1002/ppul.22875 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_miscellaneous_1547831695</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3402363941</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4665-cd8034bb071edf10fdb2b4255d9b629352aae534f27ea1a4aa4850f1919f9dfa3</originalsourceid><addsrcrecordid>eNpdkUlPwzAQhS0EomW58ANQJC5cUjzeEh_ZWhBVqKAIiYvlNDa4pEnIQum_x1DgwGlGM98bPc1D6ADwADAmJ1XV5QNC4ohvoD5gKUPMpNhEfT_hoYgF7aGdpplj7HcStlGPMAySgOijm9Oqyt1Mt64sgtIGyTSs6vIsmQSuCN5N0bpct2UdLI0uXPEcWN9XtWlNvfCE1UXbBEvXvgR3F_d7aMvqvDH7P3UXPQwvp-dX4fh2dH1-Og5nTAgezrIYU5amOAKTWcA2S0nKCOeZTAWRlBOtDafMksho0ExrFnNsQYK0MrOa7qLj9V3v9K0zTasWrpmZPNeFKbtGAWdRTEFI7tGjf-i87OrCu_MUp8CkpMRThz9Uly5MpqraLXS9Ur9v8gCsgaXLzepvD1h9BaC-AlDfAajJ5GH83XlNuNa4pjUffxpdvyoRUY8-JiOVXIgJTJ-GKqGfAuqGjg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1553149932</pqid></control><display><type>article</type><title>Application of NT-proBNP in ventilator weaning for preterm infants with RDS</title><source>MEDLINE</source><source>Wiley Online Library All Journals</source><creator>Zhang, Qian ; Shi, Zan Yang ; Luo, Cheng Han ; Wang, Li ; Zhang, Shan Shan ; Cheng, Xin Ru ; Zhang, Qin ; Xu, Qian Ya ; Guo, Hong Xiang ; Cheng, Xiu Yong ; Sheng, Guang Yao</creator><creatorcontrib>Zhang, Qian ; Shi, Zan Yang ; Luo, Cheng Han ; Wang, Li ; Zhang, Shan Shan ; Cheng, Xin Ru ; Zhang, Qin ; Xu, Qian Ya ; Guo, Hong Xiang ; Cheng, Xiu Yong ; Sheng, Guang Yao</creatorcontrib><description>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 < 0.001). The cut‐off of NT‐proBNP level 18,500 pg/ml to predict weaning failure had a positive likelihood ratio of 25.180. The addition of NT‐proBNP to SBT in prediction of weaning failure significantly improved the net reclassification improvement (NRI = 0.224; P = 0.034).
Conclusion
NT‐proBNP is an independent factor that could predict weaning failure. Measurement of NT‐proBNP prior to SBT may be helpful in promoting successful ventilator weaning along with SBT. Pediatr Pulmonol. 2014; 49:757–763. © 2013 Wiley Periodicals, Inc.</description><identifier>ISSN: 8755-6863</identifier><identifier>EISSN: 1099-0496</identifier><identifier>DOI: 10.1002/ppul.22875</identifier><identifier>PMID: 24019216</identifier><language>eng</language><publisher>United States: Blackwell Publishing Ltd</publisher><subject>Babies ; Female ; Hematocrit ; Humans ; Hypertension, Pulmonary - blood ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight ; Male ; mechanical ventilation (MV) ; N-terminal pro-B-type natriuretic peptide (NT-proBNP) ; Natriuretic Peptide, Brain - blood ; Peptide Fragments - blood ; Pneumonia, Ventilator-Associated - blood ; Potassium - blood ; Premature birth ; Prognosis ; Respiratory distress syndrome ; Respiratory Distress Syndrome, Newborn - blood ; Respiratory Distress Syndrome, Newborn - therapy ; Serum Albumin ; Sodium - blood ; spontaneous breathing trial (SBT) ; Ventilator Weaning ; Ventilators</subject><ispartof>Pediatric pulmonology, 2014-08, Vol.49 (8), p.757-763</ispartof><rights>2013 Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4665-cd8034bb071edf10fdb2b4255d9b629352aae534f27ea1a4aa4850f1919f9dfa3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fppul.22875$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fppul.22875$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24019216$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zhang, Qian</creatorcontrib><creatorcontrib>Shi, Zan Yang</creatorcontrib><creatorcontrib>Luo, Cheng Han</creatorcontrib><creatorcontrib>Wang, Li</creatorcontrib><creatorcontrib>Zhang, Shan Shan</creatorcontrib><creatorcontrib>Cheng, Xin Ru</creatorcontrib><creatorcontrib>Zhang, Qin</creatorcontrib><creatorcontrib>Xu, Qian Ya</creatorcontrib><creatorcontrib>Guo, Hong Xiang</creatorcontrib><creatorcontrib>Cheng, Xiu Yong</creatorcontrib><creatorcontrib>Sheng, Guang Yao</creatorcontrib><title>Application of NT-proBNP in ventilator weaning for preterm infants with RDS</title><title>Pediatric pulmonology</title><addtitle>Pediatr Pulmonol</addtitle><description>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 < 0.001). The cut‐off of NT‐proBNP level 18,500 pg/ml to predict weaning failure had a positive likelihood ratio of 25.180. The addition of NT‐proBNP to SBT in prediction of weaning failure significantly improved the net reclassification improvement (NRI = 0.224; P = 0.034).
Conclusion
NT‐proBNP is an independent factor that could predict weaning failure. Measurement of NT‐proBNP prior to SBT may be helpful in promoting successful ventilator weaning along with SBT. Pediatr Pulmonol. 2014; 49:757–763. © 2013 Wiley Periodicals, Inc.</description><subject>Babies</subject><subject>Female</subject><subject>Hematocrit</subject><subject>Humans</subject><subject>Hypertension, Pulmonary - blood</subject><subject>Infant, Low Birth Weight</subject><subject>Infant, Newborn</subject><subject>Infant, Premature</subject><subject>Infant, Very Low Birth Weight</subject><subject>Male</subject><subject>mechanical ventilation (MV)</subject><subject>N-terminal pro-B-type natriuretic peptide (NT-proBNP)</subject><subject>Natriuretic Peptide, Brain - blood</subject><subject>Peptide Fragments - blood</subject><subject>Pneumonia, Ventilator-Associated - blood</subject><subject>Potassium - blood</subject><subject>Premature birth</subject><subject>Prognosis</subject><subject>Respiratory distress syndrome</subject><subject>Respiratory Distress Syndrome, Newborn - blood</subject><subject>Respiratory Distress Syndrome, Newborn - therapy</subject><subject>Serum Albumin</subject><subject>Sodium - blood</subject><subject>spontaneous breathing trial (SBT)</subject><subject>Ventilator Weaning</subject><subject>Ventilators</subject><issn>8755-6863</issn><issn>1099-0496</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkUlPwzAQhS0EomW58ANQJC5cUjzeEh_ZWhBVqKAIiYvlNDa4pEnIQum_x1DgwGlGM98bPc1D6ADwADAmJ1XV5QNC4ohvoD5gKUPMpNhEfT_hoYgF7aGdpplj7HcStlGPMAySgOijm9Oqyt1Mt64sgtIGyTSs6vIsmQSuCN5N0bpct2UdLI0uXPEcWN9XtWlNvfCE1UXbBEvXvgR3F_d7aMvqvDH7P3UXPQwvp-dX4fh2dH1-Og5nTAgezrIYU5amOAKTWcA2S0nKCOeZTAWRlBOtDafMksho0ExrFnNsQYK0MrOa7qLj9V3v9K0zTasWrpmZPNeFKbtGAWdRTEFI7tGjf-i87OrCu_MUp8CkpMRThz9Uly5MpqraLXS9Ur9v8gCsgaXLzepvD1h9BaC-AlDfAajJ5GH83XlNuNa4pjUffxpdvyoRUY8-JiOVXIgJTJ-GKqGfAuqGjg</recordid><startdate>201408</startdate><enddate>201408</enddate><creator>Zhang, Qian</creator><creator>Shi, Zan Yang</creator><creator>Luo, Cheng Han</creator><creator>Wang, Li</creator><creator>Zhang, Shan Shan</creator><creator>Cheng, Xin Ru</creator><creator>Zhang, Qin</creator><creator>Xu, Qian Ya</creator><creator>Guo, Hong Xiang</creator><creator>Cheng, Xiu Yong</creator><creator>Sheng, Guang Yao</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201408</creationdate><title>Application of NT-proBNP in ventilator weaning for preterm infants with RDS</title><author>Zhang, Qian ; Shi, Zan Yang ; Luo, Cheng Han ; Wang, Li ; Zhang, Shan Shan ; Cheng, Xin Ru ; Zhang, Qin ; Xu, Qian Ya ; Guo, Hong Xiang ; Cheng, Xiu Yong ; Sheng, Guang Yao</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4665-cd8034bb071edf10fdb2b4255d9b629352aae534f27ea1a4aa4850f1919f9dfa3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Babies</topic><topic>Female</topic><topic>Hematocrit</topic><topic>Humans</topic><topic>Hypertension, Pulmonary - blood</topic><topic>Infant, Low Birth Weight</topic><topic>Infant, Newborn</topic><topic>Infant, Premature</topic><topic>Infant, Very Low Birth Weight</topic><topic>Male</topic><topic>mechanical ventilation (MV)</topic><topic>N-terminal pro-B-type natriuretic peptide (NT-proBNP)</topic><topic>Natriuretic Peptide, Brain - blood</topic><topic>Peptide Fragments - blood</topic><topic>Pneumonia, Ventilator-Associated - blood</topic><topic>Potassium - blood</topic><topic>Premature birth</topic><topic>Prognosis</topic><topic>Respiratory distress syndrome</topic><topic>Respiratory Distress Syndrome, Newborn - blood</topic><topic>Respiratory Distress Syndrome, Newborn - therapy</topic><topic>Serum Albumin</topic><topic>Sodium - blood</topic><topic>spontaneous breathing trial (SBT)</topic><topic>Ventilator Weaning</topic><topic>Ventilators</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zhang, Qian</creatorcontrib><creatorcontrib>Shi, Zan Yang</creatorcontrib><creatorcontrib>Luo, Cheng Han</creatorcontrib><creatorcontrib>Wang, Li</creatorcontrib><creatorcontrib>Zhang, Shan Shan</creatorcontrib><creatorcontrib>Cheng, Xin Ru</creatorcontrib><creatorcontrib>Zhang, Qin</creatorcontrib><creatorcontrib>Xu, Qian Ya</creatorcontrib><creatorcontrib>Guo, Hong Xiang</creatorcontrib><creatorcontrib>Cheng, Xiu Yong</creatorcontrib><creatorcontrib>Sheng, Guang Yao</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric pulmonology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhang, Qian</au><au>Shi, Zan Yang</au><au>Luo, Cheng Han</au><au>Wang, Li</au><au>Zhang, Shan Shan</au><au>Cheng, Xin Ru</au><au>Zhang, Qin</au><au>Xu, Qian Ya</au><au>Guo, Hong Xiang</au><au>Cheng, Xiu Yong</au><au>Sheng, Guang Yao</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Application of NT-proBNP in ventilator weaning for preterm infants with RDS</atitle><jtitle>Pediatric pulmonology</jtitle><addtitle>Pediatr Pulmonol</addtitle><date>2014-08</date><risdate>2014</risdate><volume>49</volume><issue>8</issue><spage>757</spage><epage>763</epage><pages>757-763</pages><issn>8755-6863</issn><eissn>1099-0496</eissn><abstract>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 < 0.001). The cut‐off of NT‐proBNP level 18,500 pg/ml to predict weaning failure had a positive likelihood ratio of 25.180. The addition of NT‐proBNP to SBT in prediction of weaning failure significantly improved the net reclassification improvement (NRI = 0.224; P = 0.034).
Conclusion
NT‐proBNP is an independent factor that could predict weaning failure. Measurement of NT‐proBNP prior to SBT may be helpful in promoting successful ventilator weaning along with SBT. Pediatr Pulmonol. 2014; 49:757–763. © 2013 Wiley Periodicals, Inc.</abstract><cop>United States</cop><pub>Blackwell Publishing Ltd</pub><pmid>24019216</pmid><doi>10.1002/ppul.22875</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Wiley Online Library All Journals |
| subjects | Babies Female Hematocrit Humans Hypertension, Pulmonary - blood Infant, Low Birth Weight Infant, Newborn Infant, Premature Infant, Very Low Birth Weight Male mechanical ventilation (MV) N-terminal pro-B-type natriuretic peptide (NT-proBNP) Natriuretic Peptide, Brain - blood Peptide Fragments - blood Pneumonia, Ventilator-Associated - blood Potassium - blood Premature birth Prognosis Respiratory distress syndrome Respiratory Distress Syndrome, Newborn - blood Respiratory Distress Syndrome, Newborn - therapy Serum Albumin Sodium - blood spontaneous breathing trial (SBT) Ventilator Weaning Ventilators |
| title | Application of NT-proBNP in ventilator weaning for preterm infants with RDS |
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