| B-Type Natriuretic Peptide in the Recognition of Critical Congenital Heart Disease in the Newborn Infant. | |
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MedLine Citation:
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PMID: 22858747 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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OBJECTIVE: Infants with congenital heart disease having obstruction to the left ventricular outflow and ductal-dependent systemic circulation can present critically ill with shock. Prompt disease recognition and initiation of prostaglandins are necessary to prevent excess morbidity and mortality. We assessed a large cohort of newborn infants with ductal-dependent systemic circulation to determine if B-type natriuretic peptide (BNP) is consistently elevated at presentation, potentially aiding in diagnosis and treatment. METHODS: The clinical records of infants with left-sided obstructive lesions admitted from January 2005 to June 2009 were reviewed. Infants were divided into 2 groups: group 1 was diagnosed with cardiogenic/circulatory shock at presentation, and group 2 consisted of infants with ductal-dependent systemic circulation without evidence of shock. B-type natriuretic peptide levels and other variables between the groups were compared. RESULTS: All patients with critical congenital heart disease presenting with shock had elevated BNP levels, ranging from 553 to greater than 5000 pg/mL. Infants in group 1 (shock, n = 36) had significantly higher median BNP levels of 4100 pg/mL at presentation compared with group 2 patients (no shock, n = 86), who had a median BNP of 656 pg/mL (range, 30-3930 pg/mL; P < 0.001). Every 100 U of increase in BNP at presentation increased the likelihood of shock (odds ratio, 100; P < 0.001). CONCLUSIONS: B-type natriuretic peptide is markedly elevated in neonates presenting in shock secondary to left-sided obstructive heart disease and is an important diagnostic tool to aid in the rapid identification and treatment of these patients. |
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Authors:
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Srikant Das; Nikhil K Chanani; Shriprasad Deshpande; Kevin O Maher |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-8-1 |
Journal Detail:
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Title: Pediatric emergency care Volume: - ISSN: 1535-1815 ISO Abbreviation: Pediatr Emerg Care Publication Date: 2012 Aug |
Date Detail:
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Created Date: 2012-8-3 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8507560 Medline TA: Pediatr Emerg Care Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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From the Sibley Heart Center Cardiology, Children's Healthcare of Atlanta, Emory University, Atlanta, GA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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