In a large series of children with congenital heart disease, researchers looked at the relationship between N-terminal pro-brain natriuretic peptide (NT-proBNP) levels at different time points and early outcome and the reliability of NT-proBNP group as a predictor of early outcome after surgery (CHD). Researchers studied 363 consecutive children with CHD in a retrospective observational study. Before 1,12, and 36 hours following surgery, they measured each patient’s plasma NT-proBNP levels. They determined NT-specificity, proBNP’s sensitivity, and predictive usefulness in predicting early postoperative outcomes.
Time-varying NT-proBNP levels, particularly 1-hour postoperative levels, were found to have predictive significance in the prediction of extended mechanical breathing, intensive care unit (ICU) stay, and inotropic therapy, according to analyses. A 1% increase in NT-proBNP was associated with 5.5%, 3.9%, and 3.5% relative increases in expected duration of mechanical ventilation, ICU stay, and inotropic therapy, respectively, according to joint modeling analyses of a linear mixed-effects model for NT-proBNP from before to 36 hours after surgery and generalized linear models for the duration of mechanical ventilation, ICU stay, and inotropic therapy. Following CHD surgery, perioperative NT-proBNP levels may be useful in identifying patients who are at a higher risk of a poor result.
Reference:www.jtcvs.org/article/S0022-5223(17)30188-5/fulltext
