Perioperative NT-proBNP level: Potential prognostic markers in children undergoing congenital heart disease surgery

Abstract Objectives To assess the relationship between N-terminal pro–brain natriuretic peptide (NT-proBNP) levels at different time points and early outcome, and to evaluate the reliability of NT-proBNP level as a predictor of early outcome after surgery in a large series of children with congenita...

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Veröffentlicht in:The Journal of thoracic and cardiovascular surgery 2017-08, Vol.154 (2), p.631-640
Hauptverfasser: Qu, Jiangbo, MD, PhD, Liang, Huiying, MD, Zhou, Na, MD, Li, Lijuan, MD, Wang, Yanfei, MD, PhD, Li, Jianbin, MD, Cui, Yanqin, MD
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Sprache:eng
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Zusammenfassung:Abstract Objectives To assess the relationship between N-terminal pro–brain natriuretic peptide (NT-proBNP) levels at different time points and early outcome, and to evaluate the reliability of NT-proBNP level as a predictor of early outcome after surgery in a large series of children with congenital heart disease (CHD). Methods A retrospective observational study involving 363 consecutive children with CHD was used. Plasma NT-proBNP records were obtained for each patient before and 1, 12, and 36 hours after surgery. The specificity, sensitivity, and prediction value of NT-proBNP in predicting early postoperative outcomes were determined. Results Analyses confirmed that time-varying NT-proBNP level, particularly 1-hour postoperative levels, had prognostic value on the prediction of prolonged duration of mechanical ventilation, intensive care unit (ICU) stay, and inotropic therapy. Joint modeling analyses of a linear mixed effects model for NT-proBNP from before to 36 hours after surgery and generalized linear models for the duration of the mechanical ventilation, ICU stay, and inotropic therapy showed that a 1% increase in NT-proBNP was associated with 5.5%, 3.9%, and 3.5% relative increases in expected duration of mechanical ventilation, ICU stay, and inotropic therapy, respectively; related P values were .001, .001, and .01, respectively. Conclusions After CHD surgery, the perioperative NT-proBNP levels might be powerful markers to identify subjects at higher risk for worse outcome.
ISSN:0022-5223
1097-685X
DOI:10.1016/j.jtcvs.2016.12.056