Intensive Care Medicine

, Volume 34, Issue 6, pp 1109–1113

Value of brain natriuretic peptide in the perioperative follow-up of children with valvular disease

  • Pierre Tissières
  • Eduardo da Cruz
  • Walid Habre
  • Yacine Aggoun
  • Noury Mensi
  • Afksendyios Kalangos
  • Maurice Beghetti
Pediatric Brief Report

DOI: 10.1007/s00134-008-1025-8

Cite this article as:
Tissières, P., da Cruz, E., Habre, W. et al. Intensive Care Med (2008) 34: 1109. doi:10.1007/s00134-008-1025-8

Abstract

Objective

To characterize N-terminal pro-brain natriuretic peptide (N-proBNP) and troponin I (TnI) profile following mitral and/or aortic valve surgery and to evaluate correlations with echocardiography measures and outcome criteria.

Design and setting

Prospective cross-controlled study in a university children's hospital.

Patients

Twenty children with acquired valvular disease requiring valvular surgery.

Interventions

We prospectively studied clinical, biochemical, and echocardiographic characteristics at baseline and 6, 12, 24 h and 3–4 weeks postoperatively.

Results

TnI peaked 6 h after surgery and remained elevated during the first 24 h. N-proBNP was significantly lower 3–4 weeks after surgery than during the perioperative period. Overall, N-proBNP was correlated with the Pediatric Heart Failure Index, left ventricle shortening fraction, left atrium to aorta ratio, left ventricle mass index, end-systolic wall stress, and with outcome measures such as inotropic score, duration of inotropic support, and ICU length of stay. Preoperative N-proBNP was significantly more elevated in patients with complicated outcome than in patients with uneventful postoperative course.

Conclusions

In pediatric valvular patients, perioperative N-proBNP is a promising risk stratification predicting factor. It is correlated with evolutive echocardiographic measures, need for inotropic support, and ICU length of stay.

Keywords

Pediatric Heart failure N-terminal pro-brain natriuretic peptide Troponin Valvular surgery Nesiritide 

Supplementary material

134_2008_1025_MOESM1_ESM.doc (30 kb)
Electronic Supplementary Material (DOC 31K)
134_2008_1025_MOESM2_ESM.doc (32 kb)
Electronic Supplementary Material (DOC 33K)
134_2008_1025_MOESM3_ESM.doc (32 kb)
Electronic Supplementary Material (DOC 33K)
134_2008_1025_MOESM4_ESM.doc (34 kb)
Electronic Supplementary Material (DOC 34K)

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Pierre Tissières
    • 1
    • 2
  • Eduardo da Cruz
    • 2
    • 3
    • 4
  • Walid Habre
    • 5
  • Yacine Aggoun
    • 3
  • Noury Mensi
    • 6
  • Afksendyios Kalangos
    • 7
  • Maurice Beghetti
    • 3
  1. 1.ICU Research Laboratory, Department of Microbiology and Molecular MedicineUniversity of Geneva Medical School, CMUGeneva 4Switzerland
  2. 2.Pediatric and Neonatal Intensive Care DivisionChildren’s University HospitalGenevaSwitzerland
  3. 3.Pediatric Cardiology Unit, Department of PediatricsChildren’s University HospitalGenevaSwitzerland
  4. 4.Pediatric Cardiac Intensive Care Unit, Section of Pediatric Cardiology, Heart InstituteChildren’s Hospital of DenverDenverUSA
  5. 5.Pediatric Anesthesia UnitUniversity HospitalGenevaSwitzerland
  6. 6.Clinical Chemistry LaboratoryUniversity HospitalGenevaSwitzerland
  7. 7.Service of Cardiovascular SurgeryUniversity HospitalGenevaSwitzerland

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