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Value of brain natriuretic peptide in the perioperative follow-up of children with valvular disease

da Cruz, Eduardo
Published in Intensive care medicine. 2008, vol. 34, no. 6, p. 1109-13
Collection Open Access - Licence nationale Springer
Abstract OBJECTIVE: To characterize N-terminal pro-brain natriuretic peptide (N-proBNP) and troponin I (TnI) profile following mitral and/or aortic valve surgery and to evaluate correlations with echocardiography measures and outcome criteria. DESIGN AND SETTING: Prospective cross-controlled study in a university children's hospital. PATIENTS: Twenty children with acquired valvular disease requiring valvular surgery. INTERVENTIONS: We prospectively studied clinical, biochemical, and echocardiographic characteristics at baseline and 6, 12, 24 h and 3-4 weeks postoperatively. RESULTS: TnI peaked 6 h after surgery and remained elevated during the first 24 h. N-proBNP was significantly lower 3-4 weeks after surgery than during the perioperative period. Overall, N-proBNP was correlated with the Pediatric Heart Failure Index, left ventricle shortening fraction, left atrium to aorta ratio, left ventricle mass index, end-systolic wall stress, and with outcome measures such as inotropic score, duration of inotropic support, and ICU length of stay. Preoperative N-proBNP was significantly more elevated in patients with complicated outcome than in patients with uneventful postoperative course. CONCLUSIONS: In pediatric valvular patients, perioperative N-proBNP is a promising risk stratification predicting factor. It is correlated with evolutive echocardiographic measures, need for inotropic support, and ICU length of stay.
Keywords Biological Markers/bloodChildEchocardiographyHeart Valve Diseases/blood/surgery/ultrasonographyHumansNatriuretic Peptide, Brain/bloodProspective StudiesROC CurveStatistics, NonparametricTreatment OutcomeTroponin/blood
PMID: 18283430
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Research groups Chirurgie cardio-vasculaire (105)
Enfants et hyperréactivité bronchique (69)
Groupe Pugin Jérôme (Soins intensifs) (587)
L'hypertension pulmonaire (pédiatrie) (228)
(ISO format)
TISSIÈRES, Pierre et al. Value of brain natriuretic peptide in the perioperative follow-up of children with valvular disease. In: Intensive care medicine, 2008, vol. 34, n° 6, p. 1109-13. doi: 10.1007/s00134-008-1025-8 https://archive-ouverte.unige.ch/unige:891

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Deposited on : 2009-02-23

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