Prognostic value of N-terminal pro-brain natriuretic peptide levels in critically ill infants

Abstract

Objective To explore the prognostic value of N-terminal pro-brain natriuretic peptide(NT-pro-BNP) levels in critically ill infants. Methods Eighty-one critically ill infants were enrolled from January 2013 to January 2014 in pediatric intensive care unit.The minimum of pediatric critical illness score(PCIS) and the number of dysfunction organs were calculated within 24 hour after admission.According to PCIS, the critically ill infants were divided into extremely critical group(PCIS≤70, n=25), critical group(PCIS 71-80, n=30)and non-critical group(PCIS>80, n=26). According to the prognosis, the critically ill infants were divided into survival group(n=68)and death group(n=13). The serum NT-pro-BNP levels were determined on the first day, third day and convalescent phase.The relationships of serum NT-pro-BNP levels with PCIS and the number of dysfunction organs and prognosis were observed. Results The study showed statistical significances of serum NT-pro-BNP levels among the extremely critical group, critical group and non-critical group, whether on the first day, or on the third day and convalescent phase(P<0.01). There were statistical significances of serum NT-pro-BNP levels among different stages of the disease in each group(P<0.01). Compared with survival group, PCIS was significantly lower and the serum NT-pro-BNP levels and the number of dysfunction organs were significantly higher in death group.The serum NT-pro-BNP level on the third day was higher than that on the first day in death group(P<0.01), while no significant difference was found in survival group.The serum NT-pro-BNP levels on the first day and the third day and PCIS were negatively correlated(r=-0.59, P<0.01; r=-0.66, P<0.01). The serum NT-pro-BNP levels on the first day and the third day and the number of dysfunction organs were positively correlated(r=0.40, P<0.05; r=0.57, P<0.01). Conclusion The serum NT-pro-BNP levels of the critically ill infants are correlated with disease severity, and can be useful for assessing the severity of critical illness. Key words: Critical illness; Infants; N-terminal pro-brain natriuretic peptide; Prognosis