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

Tissières, Pierre; da Cruz, Eduardo; Habre, Walid; Aggoun, Yacine; Mensi, Noury; Kalangos, Afksendiyos; Beghetti, Maurice

doi:10.1007/s00134-008-1025-8

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Title		Value of brain natriuretic peptide in the perioperative follow-up of children with valvular disease
Authors		Tissières, Pierre da Cruz, Eduardo Habre, Walid Aggoun, Yacine Mensi, Noury Kalangos, Afksendiyos Beghetti, Maurice
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/blood — Child — Echocardiography — Heart Valve Diseases/blood/surgery/ultrasonography — Humans — Natriuretic Peptide, Brain/blood — Prospective Studies — ROC Curve — Statistics, Nonparametric — Treatment Outcome — Troponin/blood
Identifiers		DOI: 10.1007/s00134-008-1025-8 PMID: 18283430
Full text		Article (Accepted version) (105 Kb) - Free access Other version: http://www.springerlink.com/content/hh0t3n22206ng624/fulltext.html
Structures		Faculté de médecine / Section de médecine clinique / Département d'anesthésiologie, pharmacologie, soins intensifs et urgences Faculté de médecine / Section de médecine clinique / Département de pédiatrie, gynécologie et obstétrique
Research groups		Chirurgie cardio-vasculaire (105) Enfants et hyperréactivité bronchique (69) Groupe Pugin Jérôme (Soins intensifs) (587) L'hypertension pulmonaire (pédiatrie) (228)
Citation (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