Early elevations in B-type natriuretic peptide levels are associated with poor clinical outcomes in pediatric acute lung injury.

Abstract:

OBJECTIVES:To determine B-type natriuretic peptide (BNP) levels in infants and children with acute lung injury (ALI), and to investigate associations between BNP levels and clinical outcome. DESIGN:Prospective observational study. SUBJECTS:After informed consent, plasma was collected from 48 pediatric patients on day 1 of ALI. METHODOLOGY:Plasma BNP levels were measured by immunoassay on day 1 of ALI in 48 pediatric patients. Associations between BNP levels and outcome were determined. RESULTS:The mean PaO(2)/FiO(2) at the onset of ALI was 155 (+/-74) and BNP values ranged from 5 to 2,060 pg/ml with a mean of 109 (+/-311). BNP levels were inversely correlated with ventilator-free days (Spearman rho -0.30, P = 0.04), and positively correlated with exhaled tidal volume (Spearman rho 0.44, P = 0.02). BNP levels were higher in patients receiving inotropic support (n = 12) than patients not receiving inotropic support (n = 33, P = 0.02). BNP levels were correlated with PRISM III scores (Spearman rho 0.55, P < 0.001) and PELOD scores (Spearman rho 0.4, P = 0.006). Mortality for the cohort was 15%. BNP levels were higher in non-survivors (n = 7) than survivors (n = 41, P = 0.055). CONCLUSIONS:BNP levels are elevated in children with ALI/ARDS early in the disease course, and increased levels are associated with worse clinical outcome.

journal_name

Pediatr Pulmonol

journal_title

Pediatric pulmonology

authors

Reel B,Oishi PE,Hsu JH,Gildengorin G,Matthay MA,Fineman JR,Flori H

doi

10.1002/ppul.21111

subject

Has Abstract

pub_date

2009-11-01 00:00:00

pages

1118-24

issue

11

eissn

8755-6863

issn

1099-0496

journal_volume

44

pub_type

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