This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (1) Citing Articles via Google Scholar Google Scholar Articles by Cannesson, M. Articles by Lehot, J.-J. Search for Related Content PubMed PubMed Citation Articles by Cannesson, M. Articles by Lehot, J.-J.

---

PEDIATRIC ANESTHESIA

Time Course and Prognostic Value of Plasma B-type Natriuretic Peptide Concentration in Neonates Undergoing the Arterial Switch Operation

Maxime Cannesson, MD^*, Clara Bionda, MD, Bruno Gostoli, MD^*, Olivier Raisky, MD, PhD, Sylvie di Filippo, MD, PhD, Dominique Bompard, MD^*, Catherine Védrinne, MD, PhD^*, Robert Rousson, MD, PhD, Jean Ninet, MD, Jean Neidecker, MD^*, and Jean-Jacques Lehot, MD, PhD^*

From the Departments of *Anesthesiology and Intensive Care, Biochemistry, Cardiac Surgery, and Pediatric Cardiology, Hospices Civils de Lyon, Louis Pradel Hospital and Claude Bernard Lyon 1 University, Lyon, France.

Address correspondence and reprint requests to Maxime Cannesson, Service d'Anesthésie Réanimation, Hôpital Cardiologique Louis Pradel, 200 avenue du Doyen Lépine, 69500 Bron, France. Address e-mail to maxime_cannesson{at}hotmail.com.

BACKGROUND: Plasma B-type natriuretic peptide (BNP) can predict postoperative complications after cardiac surgery in adults. Our aim was to investigate BNP kinetics and prognostic value in neonates undergoing the arterial switch operation (ASO) for transposition of the great arteries (TGA).

METHODS: We measured BNP concentrations in 30 neonates before, immediately after, and 6, 12, 24, and 48 h after ASO for TGA. Complicated postoperative evolution was defined as patients requiring mechanical ventilation or presenting low cardiac output syndrome for more than 72 h. We studied the ability of postoperative BNP concentrations to predict complicated evolution.

RESULTS: Intubation duration, inotropic support duration, and intensive care unit stay were 68 (48–121) h, 78 (69–141) h, and 96 (76–149) h respectively. Patients with complicated evolution had higher 6 and 12-h BNP concentrations than patients with simple evolution (459 (210–897) vs 137 (67–248) ng/L and 547 (193–868) vs 185 (79–354) ng/L respectively; P < 0.05) and had longer intubation, inotropic support, and intensive care unit stay (96 (70–190) vs 50 (48–66) h, 100 (83–190) vs 70 (59–72) h, and 120 (90–240) vs 84 (72–96) h, P < 0.05). A 6-h BNP concentration >160 ng/L was able to predict complicated evolution with a sensitivity of 93% and a specificity of 67%.

CONCLUSION: In neonates, BNP concentrations can predict adverse outcome in the postoperative period after ASO for TGA. This marker has potential clinical applications.

This article has been cited by other articles:

				S. Attaran, R. Sherwood, J. Desai, R. Langworthy, P. Mhandu, L. John, and A. El-Gamel Brain natriuretic peptide a predictive marker in cardiac surgery Interactive CardioVascular and Thoracic Surgery, October 1, 2009; 9(4): 662 - 666. [Abstract] [Full Text] [PDF]

				J T Attridge, D A Kaufman, and D S Lim B-type natriuretic peptide concentrations to guide treatment of patent ductus arteriosus Arch. Dis. Child. Fetal Neonatal Ed., May 1, 2009; 94(3): F178 - F182. [Abstract] [Full Text] [PDF]

				J.-H. Hsu, P. E. Oishi, R. L. Keller, O. Chikovani, T. R. Karl, A. Azakie, I. Adatia, and J. R. Fineman Perioperative B-type natriuretic peptide levels predict outcome after bidirectional cavopulmonary anastomosis and total cavopulmonary connection. J. Thorac. Cardiovasc. Surg., April 1, 2008; 135(4): 746 - 753. [Abstract] [Full Text] [PDF]