fbpx
You Are Reading

Research: Increased proBNP during extracorporeal life support (ECLS) is associated with poor outcome in neonates with congenital diaphragmatic hernia

0
Uncategorized

Research: Increased proBNP during extracorporeal life support (ECLS) is associated with poor outcome in neonates with congenital diaphragmatic hernia

J Pediatr

. 2021 Sep 27;S0022-3476(21)00910-0. doi: 10.1016/j.jpeds.2021.09.034. Online ahead of print. https://pubmed.ncbi.nlm.nih.gov/34592260/

Increased proBNP during extracorporeal life support (ECLS) is associated with poor outcome in neonates with congenital diaphragmatic hernia

Florian Kipfmueller 1Julian Balks 2Kristina Gries 2Stefan Holdenrieder 3Andreas Mueller 2Florian Kipfmueller 2Affiliations expand

Abstract

Objectives: To evaluate the prognostic information derived from the daily measurements of proBNP in neonates with congenital diaphragmatic hernia (CDH) undergoing extracorporeal life support (ECLS).

Study design: Plasma proBNP was prospectively measured daily during the first week of ECLS using an electrochemiluminescence immunoassay. Patients (n=63) were allocated according to outcome: survivors (group 1, n=35); non-survivors with successful weaning (defined as survival for >12h after ECLS discontinuation) (group 2, n=16); non-survivors with unsuccessful weaning (group 3, n=12). ProBNP kinetics were compared using Kruskal-Wallis testing and correlated with pulmonary hypertension and cardiac dysfunction on echocardiography using the Spearman correlation coefficient.

Results: Infants in group 3 presented significantly higher proBNP values from day 3 to day 6 compared with group 1 and 2. Overall mortality among patients with the highest proBNP values on day 1 was 30.6% compared with 63% in those patients with at least one higher value on day 2 to day 7. In patients with a late increase (day 4 to day 7) in proBNP the mortality was 70%, compared with 32.6% in those with proBNP below the value on day 1. Weaning failure was 35% in patients with a late increase and 11.6% in those without a late increase. ProBNP correlated significantly with PH and cardiac dysfunction before and during ECLS.

Conclusions: Absolute proBNP values are associated with weaning failure but not overall mortality in neonates with CDH undergoing ECLS. Echocardiographic findings correlate well with proBNP values.

Keywords: BNP; cardiac dysfunction; extracorporeal life support; natriuretic peptides; pulmonary hypertension.

cuevana 3

Follow @ Instagram

Translate »

TasteKid.com provides Menu of different Restaurant. Now get all Restaurant Menu, Prices, Catering, Near Me locations, Open Hours. You can quickly find Near me Restaurants around your place.

123 movies soap2day