Early Fluid Administration in Extremely Preterm Newborns (with Birth Body Mass ≤1200G) and its Relationship with the Level of NT-PROBNP and PDA

Abstract

Background: Patent arterial duct [PDA] is a common problem in extremely preterm babies. Its hemodynamic significance is considered to be partly dependent on fluid management, especially in extremely low birth weight preterms [ELBW]. Some authors propose N-terminal pro Brain Natriuretic Peptide[NT-proBNP] as an indicator of significance of PDA. The aim of our study is to check the relationship between early intravenous fluid intake, the level of NT-proBNP and PDA diameter. Methods: Between 2009 and 2011, twenty ELBW preterms were included for the study. The main inclusion criteria were: birth mass ≤1200g, birth age ≤28 weeks. Blood sample for NT-proBNP measurement just after delivery and in the second day of life were collected. An echocardiography was performed simultaneously with the second sample for NT-proBNP. The diameter of arterial duct and, the LA/Ao ratio were measured. Total fluid administration [TFA] until the moment of the second NT-proBNP collection was calculated and expressed as ml/kg/h. The results were compared and analyzed. Five newborns were excluded from the analysis. Results: Median diameter of PDA, La/Ao ratio, TFA, NT-proBNP level in three groups of patients are presented below: Table Conclusions: NT-proBNP is a useful tool for indication of hemodynamic significance of PDA. Intravenous fluid administrated according to patient requirements, influences neither the diameter of PDA nor NT-proBNP level.