Usefulness of Serum Brain Natriuretic Peptide Level for Screening Hemodynamically Significant Patent Ductus Arteriosus in Preterm Neonates |
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Authors: | Ahmad Jameii Khosroshahi Ali Kianfar Behzad Mohammadpour Aharanjani Keyhan Sayadpour Zanjani |
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Affiliation: | 1.Department of Pediatrics, Shaheed Madani Hospital, Tabriz University of Medical Sciences, Tabriz.;2.Motahhari Educational Hospital, Urmia University of Medical Sciences, Urmia.;3.Department of Pediatrics.;4.Baharmi Hospital.;5.Children’s Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran |
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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.Findings: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).Conclusion: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. |
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Keywords: | Brain natriuretic peptide Patent Ductus Arteriosus Echocardiography Ibuprofen |
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