Document Detail


B-type natriuretic peptide predicts responses to indomethacin in premature neonates with patent ductus arteriosus.
MedLine Citation:
PMID:  20227723     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To determine whether B-type natriuretic peptide (BNP) predicts indomethacin responsiveness in premature neonates with patent ductus arteriosus (PDA). STUDY DESIGN: Premature neonates receiving indomethacin for an echocardiograhically large (diameter>1.5 mm) and clinically significant PDA were prospectively studied. All neonates underwent paired echocardiography and BNP measurements at baseline and 24 hours after each dose of indomethacin. After treatment, neonates who responded (with closed or insignificant PDA) and neonates who did not respond (with persistent significant PDA requiring surgical ligation) were compared. RESULTS: Thirty-one premature neonates (mean gestational age, 30 weeks) underwent 119 paired echocardiography and BNP determinations. Mean BNP levels (1286+/-986 pg/mL) associated with significant PDA (n=96) were higher than those associated with closed or insignificant PDA (n=23; 118+/-124 pg/mL; P<.001). Twenty-three neonates responded and 8 neonates did not respond to indomethacin. Mean baseline BNP levels were higher in neonates who were non-responders (2234+/-991 pg/mL) than neonates who were responders (983+/-814 pg/mL; P=.001). A baseline BNP level>1805 pg/mL had a sensitivity rate of 88% and a specificity rate of 87% for predicting indomethacin non-responsiveness (P=.003). CONCLUSIONS: High baseline BNP levels predict poor responses to indomethacin and the need for surgery in premature neonates with PDA.
Authors:
Jong-Hau Hsu; San-Nan Yang; Hsiu-Lin Chen; Hsing-I Tseng; Zen-Kong Dai; Jiunn-Ren Wu
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-03-15
Journal Detail:
Title:  The Journal of pediatrics     Volume:  157     ISSN:  1097-6833     ISO Abbreviation:  J. Pediatr.     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-06-15     Completed Date:  2010-09-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  79-84     Citation Subset:  AIM; IM    
Copyright Information:
Copyright (c) 2010 Mosby, Inc. All rights reserved.
Affiliation:
Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
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MeSH Terms
Descriptor/Qualifier:
Cardiovascular Agents / administration & dosage,  therapeutic use*
Cyclooxygenase Inhibitors / administration & dosage,  therapeutic use*
Ductus Arteriosus, Patent / blood,  drug therapy*,  ultrasonography
Female
Gestational Age
Humans
Indomethacin / administration & dosage,  therapeutic use*
Infant, Newborn
Infant, Premature* / blood
Male
Natriuretic Peptide, Brain / blood*
Predictive Value of Tests
Pregnancy
Severity of Illness Index
Treatment Outcome
Chemical
Reg. No./Substance:
0/Cardiovascular Agents; 0/Cyclooxygenase Inhibitors; 114471-18-0/Natriuretic Peptide, Brain; 53-86-1/Indomethacin

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