title: Usefulness of serum brain natriuretic Peptide level for screening hemodynamically significant patent ductus arteriosus in preterm neonates.
abstract: OBJECTIVE
  We studied usefulness of serum B-type natriuretic peptide level as a screening tool for detecting hemodynamically significant patent ductus arteriosus in the preterm neonates.
  
  
  METHODS
  Sixty admitted preterm neonates with gestational age ≤34 weeks, birth weight ≤2500 gr, and age of >3 days have been enrolled in this study. We measured serum B-type natriuretic peptide levels at the beginning and after completion of drug therapy for ductus occlusion.
  
  
  RESULTS
  Mean±SD gestational age and weight was 31±1.9 weeks and 1680±350 gr, respectively. The peptide levels in the neonates with significant duct (n=13) were significantly higher than in those with insignificant duct (n=17) or no duct (n=30) (1667±821 pg/ml versus 667±666 and 309±171, respectively). The peptide level dropped significantly after ibuprofen administration in the neonates with significant PDA (n=13), (1667±1165 pg/ml to 429±386).
  
  
  CONCLUSIONS
  At a cutoff point of 450 pg/ml, B-type natriuretic peptide level had a sensitivity of 92% and specificity of 87%, the negative predictive value of 98.5%, the positive likelihood ratio of 6.92 and the negative likelihood ratio of 0.089 for detecting significant patent duct. Levels below this can eliminate the need for echocardiography.
authors.affiliation: Department of Pediatrics, Shaheed Madani Hospital, Tabriz University of Medical Sciences, Tabriz.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Jameii Khosroshahi
authors.affiliation: Motahhari Educational Hospital, Urmia University of Medical Sciences, Urmia.
authors.forename: Ali
authors.initials: A
authors.lastname: Kianfar
authors.affiliation: Department of Pediatrics, ; Baharmi Hospital.
authors.forename: Behzad
authors.initials: B
authors.lastname: Mohammadpour Aharanjani
authors.affiliation: Department of Pediatrics, ; Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Keyhan
authors.initials: K
authors.lastname: Sayadpour Zanjani
keywords: Brain natriuretic peptide; Echocardiography; Ibuprofen; Patent Ductus Arteriosus