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NT-PROBNP as a screening tool for low-risk patent ductus arteriousus: a follow-up validation study

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Abstract

The purpose of the study is to test whether NT-proBNP serves as a screening tool for low-risk patent ductus arteriosus and safely avoids routine early echocardiography. This is a prospective observational study in preterm infants ≤32 weeks of gestational age. Infants with ≥5100 pg/ml (positive screening) at 48–72 hours of life received comprehensive echocardiography and were treated according to shunt severity. Infants with NT-proBNP below 5100 pg/ml (negative screening) were managed expectantly. The main outcome was need for ductus treatment within the first 7 days of life. One hundred twenty-five infants were included; 82 had a negative NT-proBNP screening and 43 had a positive NT-proBNP screening. No infant (0%) with a negative screening was treated for ductus while 26 (60.4%) with a positive screening were treated (p < 0.001). NT-proBNP avoided a 65.6% of routine echocardiograms. NT-proBNP had an excellent performance to predict PDA treatment (AUC = 0.967).

Conclusion: NT-proBNP at 48–72 hours of life has an excellent performance to detect low risk and avoids unnecessary echocardiograms. This may contribute to optimize PDA management in terms of resource utilization.

What is Known:

• Patent ductus arteriosus is associated with significant morbidity in preterm infants.

• Early echocardiography screening and individualized treatment of high-risk preterm infants may improve outcomes but is resource consuming.

What is New:

• NT-proBNP can be used as a screening tool to detect low-risk patent ductus arteriosus.

• Using NT-proBNP as a screening tool safely avoids a significant proportion of routine echocardiography and may improve resource utilization.

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Author information

Author notes

  1. Gloria López-Blanco and Ignacio Oulego-Erroz contributed equally to this work.

Authors and Affiliations

  1. Department of Pediatrics, Complejo Asistencial Universitario de León, León, Spain

    Gloria López-Blanco, Álvaro Pou-Blázquez & Carlos Medina-Guerrero

  2. Biomedicine Institute of León, University of León, León, Spain

    Gloria López-Blanco & Ignacio Oulego-Erroz

  3. Pediatric Cardiology and Pediatric Intensive Care Unit, Complejo Asistencial Universitario de León, Altos de Nava s/n, 24008, León, Spain

    Ignacio Oulego-Erroz

  4. Neonatal Intensive Care Unit, Complejo Asistencial Universitario de León, León, Spain

    Silvia Rodríguez-Blanco & Paula Alonso-Quintela

  5. Neonatal Intensive Care Unit, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago, Spain

    Alejandro Pérez-Muñuzuri & Mari Luz Couce-Pico

Authors
  1. Gloria López-Blanco
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Contributions

GLB and IOE conceived and designed the study, analyzed data, drafter the manuscript and are fully accountable for all aspects of the manuscript. APV, CMG, PAQ, SRB, APM, MCP made substantial contributions to the design, acquired data, interpreted data, critically reviewed the manuscript and are fully accountable for all aspects of the present work. All authors gave their approval to the final version.

Corresponding author

Correspondence to Ignacio Oulego-Erroz.

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Ethics approval

The present study has been approved by the local Institutional Review Board (Comité Ético de Investigation de las Áreas de León y El Bierzo).

Consent to participate

Parents or legal guardians gave their informed consent for participation. The study was performed in accordance with the last version of the Declaratión of Helsinki.

Competing interests

The authors declare no competing interests.

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Communicated by: Daniele De Luca

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López-Blanco, G., Oulego-Erroz, I., Pou-Blázquez, Á. et al. NT-PROBNP as a screening tool for low-risk patent ductus arteriousus: a follow-up validation study. Eur J Pediatr 182, 5465–5471 (2023). https://doi.org/10.1007/s00431-023-05213-8

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