N-terminal pro-brain natriuretic peptide as a predictor of hemodynamic significance of functioning ductus arteriosus in premature newborns

Abstract

Objective. To study the possibility of using N-terminal pro-BNP fragment as a screening criterion of hemodynamic significant of the functioning arterial duct in extremely premature newborns. Hemodynamically significant functioning arterial duct (HSFAD) is a reason of the development of various complications in extremely premature newborns. The basic method for HSFAD diagnosis is Echo CG. The limited technical abilities of ultrasound devices can prevent from an early diagnosis and timely treatment of this state. The search of additional markers of hemodynamic significance the functioning arterial duct (FAD) is actual.
 Materials and methods. A continuous prospective observational study included patients aged 1 to 3 days with FAD, gestation period of 2532 weeks and birth weight from 500 to 1500 g. Hemodynamic significance of FAD was determined according to generally accepted Eco CG criteria. The level of NT-pro-BNP was identified with IFA on the third day of life. Mathematical modelling was used to calculate a threshold value of NT-pro-BNP, corresponding to 6500 pg/ml, at which the probability of hemodynamic significance of the functioning arterial duct exceeds 80 %.
 Results. The assessment of NT-pro BNP concentration on the third day of life permitted to establish the following reliable differences: in the main group, the median concentration for NT-pro BNP was 15000 [IQR 2 587; 26 500] pg/ml, in the comparison group 1920 [IQR 1379; 3467] pg/ml, р = 0.001. Mean force direct correlation, r = 0.52, between Echo CG results and NT-pro-BNP values was stated.
 Conclusions. The obtained results make it possible to use NT-pro-BNP as a screening criterion of FAD hemodynamic significance in extremely premature newborns.