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Title

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

Authors
da Cruz, Eduardo
Published in Intensive Care Medicine. 2008, vol. 34, no. 6, p. 1109-13
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
Identifiers
PMID: 18283430
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Structures
Research groups Chirurgie cardio-vasculaire (105)
L'hypertension pulmonaire (pédiatrie) (228)
Groupe Pugin Jérôme (Soins intensifs) (587)
Enfants et hyperréactivité bronchique (69)
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(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. https://archive-ouverte.unige.ch/unige:891

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Deposited on : 2009-02-23

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