Document Detail

Clinical implication of blood levels of B-type natriuretic peptide in pediatric patients on mechanical circulatory support.
MedLine Citation:
PMID:  16731165     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: B-type natriuretic peptide (BNP) is a marker of heart failure. In adult patients with heart failure, decreased BNP levels after implantation of ventricular assist devices may be indicative of recovery. However, BNP levels among pediatric patients receiving mechanical support are largely unknown. METHODS: Fifteen pediatric patients with cardiogenic shock who were supported by extracorporeal membrane oxygenation (ECMO) were evaluated. The BNP levels were determined before ECMO initiation, during ECMO support, and after ECMO removal. RESULTS: All patients had elevated BNP levels before initiation of ECMO (median, 1,430 pg/mL; range, 361 to 5,000 pg/mL). Among the 15 patients, 1 received heart transplantation. Extracorporeal membrane oxygenation was withdrawn in 2 patients, and the other 12 patients were weaned from ECMO. Four patients died after initially successful weaning from ECMO. The BNP levels of the nonsurvivors (median, 3,685 pg/mL; range, 2,494 to 5,000 pg/mL) were higher than those of the survivors (median, 1,127pg/mL; range, 108 to 3,030 pg/mL) on the next few days after ECMO removal (p = 0.016). The BNP levels on the fourth day after removal of ECMO among the survivors (median, 498 pg/mL; range, 108 to 890 pg/mL) were lower than those among the nonsurvivors (median, 3,900 pg/mL; range, 3,230 to 5,000 pg/mL; p = 0.017). CONCLUSIONS: Among pediatric patients supported with ECMO, the survivors had lower BNP levels than those who did not survive. We suggest that serial blood BNP levels can be potential markers for monitoring pediatric patients on mechanical circulatory support, and the concept merits further study.
Shu-Chien Huang; En-Ting Wu; Wen-Je Ko; Ling-Ping Lai; Juin Hsu; Chung-I Chang; Ing-Sh Chiu; Shoei-Shen Wang; Mei-Hwan Wu; Fang-Yue Lin; Yih-Sharng Chen
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  81     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2006 Jun 
Date Detail:
Created Date:  2006-05-29     Completed Date:  2007-09-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  2267-72     Citation Subset:  AIM; IM    
Department of Surgery, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.
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MeSH Terms
Biological Markers
Cardiac Output, Low / complications
Cardiopulmonary Bypass
Child, Preschool
Cohort Studies
Extracorporeal Membrane Oxygenation* / instrumentation
Heart Arrest / therapy
Infant, Newborn
Intensive Care
Natriuretic Peptide, Brain / blood*
Postoperative Complications / blood,  etiology,  mortality,  therapy
Predictive Value of Tests
Prospective Studies
Shock, Cardiogenic / blood,  etiology,  mortality,  therapy*
Survival Analysis
Treatment Outcome
Reg. No./Substance:
0/Biological Markers; 114471-18-0/Natriuretic Peptide, Brain
Comment In:
Ann Thorac Surg. 2006 Jun;81(6):2272   [PMID:  16731166 ]

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