title: Clinical utility of B-type natriuretic peptide (NP) in pediatric cardiac surgery--a systematic review.
abstract: BACKGROUND
  NP is a biomarker that has been used in the diagnosis, management, and prognostication of a number of cardiovascular disorders in the pediatric population. The physiological role of this hormone is to allow the myocardium to adapt to stress or strain imposed by a volume and/or pressure load.
  
  
  OBJECTIVE
  The aim of this study was to determine the utility of preoperative and postoperative NP to predict outcome in pediatric patients undergoing cardiac surgery for structural congenital heart disease.
  
  
  METHODS
  We conducted a systematic review by searching three electronic databases using the search terms 'paediatric' or 'pediatric' and 'B-type natriuretic peptide'. Twenty peer-reviewed papers were included in the study.
  
  
  RESULTS
  Preoperative NP levels were associated with the severity of cardiac failure in several studies. Preoperative NPs also correlated with early postoperative outcome measures such as duration of cardiopulmonary bypass, duration of mechanical ventilation, presence of low cardiac output syndrome, length of stay in the intensive care unit and in one study, death. Early (within 24 h) postoperative NPs showed a stronger correlation than preoperative NPs to early postoperative adverse events.
  
  
  CONCLUSIONS
  NPs provide a simple, noninvasive and complementary tool to echocardiography that can be used to assist clinicians in the assessment and management of pediatric patients with congenital heart disease in the perioperative period.
authors: Department of Anaesthetics, University of Cape Town, Cape Town, South Africa.
authors: Nura
authors: N
authors: Afshani
authors: Simone
authors: S
authors: Schülein
authors: Bruce M
authors: BM
authors: Biccard
authors: Jenny M
authors: JM
authors: Thomas
mesh_terms: D015415:Biomarkers / Q000097:blood; D002303:Cardiac Output, Low / Q000097:blood; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass / Q000706:statistics & numerical data; D002648:Child; D006330:Heart Defects, Congenital / Q000097:blood* / Q000601:surgery*; D006333:Heart Failure / Q000097:blood; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010372:Pediatrics / Q000379:methods*; D059035:Perioperative Period; D011184:Postoperative Period; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D013997:Time Factors
chemical_list: D015415:Biomarkers; D020097:Natriuretic Peptide, Brain
keywords: B-type natriuretic peptide; cardiac surgery; congenital heart disease; paediatric; pediatric