The use of a bedside assay for plasma B-type natriuretic peptide as a biomarker in the management of patent ductus arteriosus in premature neonates.
OBJECTIVE
To test the utility of the bedside plasma concentration of B-type natriuretic peptide (BNP) assay as a screen for patent ductus arteriosus (PDA) in premature neonates.


METHODS
Newborn infants admitted to the neonatal intensive care unit (NICU) had paired echocardiography and BNP measurements at enrollment and every 4 to 5 days.


RESULTS
Twenty neonates (gestational age approximately 28.6 weeks and birth weight approximately 1161 g) had 81 paired echocardiography and BNP determinations. BNP ranged from 5 to 3900 pg/mL. Fifty-six of 81 echocardiograms showed PDA. Significant correlations were found between BNP and ductal size and degree of shunting. Correlation was greater in infants >2 days of age. BNP >300 pg/mL predicted significant PDA, whereas BNP <105 pg/mL predicted absence of significant PDA.


CONCLUSIONS
Bedside measurement of BNP correlates with magnitude of PDA in premature newborns, particularly beyond day 2, and may be useful in guiding diagnostic and management strategies.
Flynn
Patrick A
PA
Division of Pediatric Cardiology, Weill-Cornell Children's Hospital, New York, NY, USA. paflynn@med.cornell.edu
da Graca
Ralph L
RL
Auld
Peter A M
PA
Nesin
Mirjana
M
Kleinman
Charles S
CS
D015415:Biomarkers; D004374:Ductus Arteriosus, Patent / Q000175:diagnosis*; D004452:Echocardiography; D005455:Fluorescent Antibody Technique; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D015997:Neonatal Screening / Q000379:methods*; D019095:Point-of-Care Systems; D012680:Sensitivity and Specificity
D015415:Biomarkers; D020097:Natriuretic Peptide, Brain