title: B-type natriuretic peptide and mortality in extremely low birth weight infants with pulmonary hypertension: a retrospective cohort analysis.
abstract: BACKGROUND
  B-type natriuretic peptide (BNP) is a strong predictor of mortality in adult patients with various forms of pulmonary hypertension (PH) and may be a strong prognostic marker in extremely low birth weight (ELBW) infants with bronchopulmonary dysplasia (BPD) associated PH as well. We sought to assess the relationship between BNP levels and all-cause mortality in a cohort of ELBW infants with BPD and PH.
  
  
  METHODS
  We retrospectively identified ELBW infants with BPD and PH who had serum BNP levels measured as part of routine clinical care in the neonatal intensive care unit. Peak serum BNP levels were correlated with survival to discharge or death.
  
  
  RESULTS
  Thirty-six ELBW infants (mean gestational age 26.0 ± 1.9 weeks and mean birth weight 740 ± 290 grams) with BPD and PH had available survival data and had serum BNP levels measured. Peak BNP level was significantly lower among infants who survived than among those who died (128 pg/ml, [IQR 23 to 463] vs. 997 pg/ml, [IQR 278 to 1770], P < 0.004). On multivariate Cox proportional hazard analysis, BNP predicted survival independent of age, gender, and BPD severity. Area under receiver operator characteristic analysis identified a BNP value of 220 pg/ml to have 90% sensitivity and 65% specificity in predicting mortality.
  
  
  CONCLUSIONS
  BNP estimation may be useful as a prognostic marker of all-cause mortality in ELBW infants with BPD associated PH.
authors.forename: Alain
authors.initials: A
authors.lastname: Cuna
authors.forename: Jegen
authors.initials: J
authors.lastname: Kandasamy
authors.affiliation: Department of Pediatrics, Division of Neonatology, University of Alabama at Birmingham, 619 S 19th St, Birmingham AL, 35249, USA. bsims@peds.uab.edu.
authors.forename: Brian
authors.initials: B
authors.lastname: Sims
mesh_terms: D001997:Bronchopulmonary Dysplasia / Q000097:blood* / Q000401:mortality*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000097:blood* / Q000401:mortality*; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D012189:Retrospective Studies
chemical_list: D020097:Natriuretic Peptide, Brain