Usefulness of serum brain natriuretic peptide level for screening hemodynamically significant patent ductus arteriosus in preterm neonates

Khosroshahi, A.J and Kianfar, A and Aharanjani, B.M and Zanjani, K.S (2014) Usefulness of serum brain natriuretic peptide level for screening hemodynamically significant patent ductus arteriosus in preterm neonates. Iranian Journal of Pediatrics, 24 (6). pp. 769-772.

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Abstract

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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