title: Can early B-type natriuretic peptide assays predict symptomatic patent ductus arteriosus in extremely low birth weight infants?
abstract: BACKGROUND
  Earlier and more accurate identification of a high-risk group of preterm infants that are likely to develop a hemodynamically significant patent ductus arteriosus (hsPDA) would allow specific targeting of early treatment and thus possibly minimize the morbidity and mortality associated with a PDA in extremely low birth weight (ELBW) infants.
  
  
  OBJECTIVE
  To investigate the predictability of B-type natriuretic peptide (BNP) for early targeted treatment of hsPDA in ELBW infants.
  
  
  METHODS
  73 ELBW infants that underwent echocardiographic evaluation and plasma BNP measurement after birth were enrolled. 31 infants developed hsPDA (HsPDA group) and 42 infants did not develop hsPDA (nPDA group).
  
  
  RESULTS
  BNP levels of the HsPDA group were significantly higher than those of the nPDA group at 24 h of age (921 [318-2,133] vs. 152 [91-450] pg/ml) but not different at 12 h of age. BNP levels at 24 h of age were significantly correlated with the magnitudes of the ductal shunt but not at 12 h of age. The area under the receiver operator characteristic curve of BNP levels for prediction of hsPDA at 24 h of age was 0.830. At the cutoff BNP levels of 200 and 900 pg/ml at 24 h of age, sensitivity was 83.9 and 54.8% and specificity was 61.9 and 95.2%, respectively.
  
  
  CONCLUSIONS
  BNP levels at 24 h of age can be used as a guide for early targeted treatment of hsPDA and avoid the unnecessary use of cyclooxygenase inhibitors in ELBW infants.
authors.affiliation: Department of Pediatrics, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Jang Hoon
authors.initials: JH
authors.lastname: Lee
authors.forename: Jeong Hee
authors.initials: JH
authors.lastname: Shin
authors.forename: Kyu Hee
authors.initials: KH
authors.lastname: Park
authors.forename: Young Jun
authors.initials: YJ
authors.lastname: Rhie
authors.forename: Moon Sung
authors.initials: MS
authors.lastname: Park
authors.forename: Byung Min
authors.initials: BM
authors.lastname: Choi
mesh_terms: D004374:Ductus Arteriosus, Patent / Q000175:diagnosis* / Q000000981:diagnostic imaging; D005260:Female; D005865:Gestational Age; D006801:Humans; D052577:Infant, Extremely Low Birth Weight / Q000097:blood*; D007231:Infant, Newborn; D007234:Infant, Premature / Q000097:blood*; D007235:Infant, Premature, Diseases / Q000097:blood* / Q000000981:diagnostic imaging; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D012372:ROC Curve; D012189:Retrospective Studies; D014463:Ultrasonography
chemical_list: D020097:Natriuretic Peptide, Brain