title: B-type natriuretic peptide and rebound during treatment for persistent pulmonary hypertension.
abstract: OBJECTIVE
  To investigate whether serum B-type natriuretic peptide (BNP) is a useful biomarker in evaluating the course of persistent pulmonary hypertension of the newborn (PPHN) and the effectiveness of treatment.
  
  
  METHODS
  Prospective follow-up study of infants with clinical and echocardiographic signs of PPHN, who were treated with inhaled nitric oxide (iNO). Of 24 patients with PPHN who were treated, serum BNP levels were determined longitudinally in 21. BNP levels were compared between infants with (n = 6) and without rebound PPHN (n = 15).
  
  
  RESULTS
  BNP levels in all infants with PPHN were not significantly different at the initial start of iNO. BNP levels decreased in both groups during iNO treatment. In the infants in whom rebound PPHN developed after weaning from iNO, a significantly higher increase was found in BNP (283 pmol/L to 1232 pmol/L) compared with that in infants without rebound (98 pmol/L to 159 pmol/L). This occurred before the onset of clinical deterioration. BNP again decreased significantly after iNO treatment was restarted.
  
  
  CONCLUSIONS
  BNP, a biomarker of cardiac ventricular strain, proved to be useful in evaluating the efficacy of PPHN treatment, and moreover, BNP helps to predict a rebound of PPHN.
authors.affiliation: Department of Neonatology, University Medical Center, Utrecht, The Netherlands. D.C.Vijlbrief@umcutrecht.nl
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Vijlbrief
authors.forename: Manon J N L
authors.initials: MJ
authors.lastname: Benders
authors.forename: Hans
authors.initials: H
authors.lastname: Kemperman
authors.forename: Frank
authors.initials: F
authors.lastname: van Bel
authors.forename: Willem B
authors.initials: WB
authors.lastname: de Vries
mesh_terms: D000280:Administration, Inhalation; D015415:Biomarkers / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D009569:Nitric Oxide / Q000008:administration & dosage / Q000627:therapeutic use*; D010547:Persistent Fetal Circulation Syndrome / Q000097:blood*; D011446:Prospective Studies
chemical_list: D015415:Biomarkers; D020097:Natriuretic Peptide, Brain; D009569:Nitric Oxide