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Application of NT-proBNP in ventilator weaning for preterm infants with RDS
Pediatric pulmonology, 2014-08, Vol.49 (8), p.757-763
Zhang, Qian
Shi, Zan Yang
Luo, Cheng Han
Wang, Li
Zhang, Shan Shan
Cheng, Xin Ru
Zhang, Qin
Xu, Qian Ya
Guo, Hong Xiang
Cheng, Xiu Yong
Sheng, Guang Yao
2014
Volltextzugriff (PDF)
Details
Autor(en) / Beteiligte
Zhang, Qian
Shi, Zan Yang
Luo, Cheng Han
Wang, Li
Zhang, Shan Shan
Cheng, Xin Ru
Zhang, Qin
Xu, Qian Ya
Guo, Hong Xiang
Cheng, Xiu Yong
Sheng, Guang Yao
Titel
Application of NT-proBNP in ventilator weaning for preterm infants with RDS
Ist Teil von
Pediatric pulmonology, 2014-08, Vol.49 (8), p.757-763
Ort / Verlag
United States: Blackwell Publishing Ltd
Erscheinungsjahr
2014
Quelle
Wiley Online Library Journals Frontfile Complete
Beschreibungen/Notizen
Summary Objective To evaluate the value of N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP) levels along with spontaneous breathing trial (SBT) in the prediction of ventilator weaning outcome among respiratory distress syndrome (RDS) preterm infants ready to wean. Methods NT‐proBNP along with plasma albumin concentration, serum sodium, serum potassium, and hematocrit were measured immediately before SBT in preterm infants (≤32 weeks) mechanically ventilated due to RDS. Extubation was considered successful if infants remained extubated >48 hr. Either SBT failure or extubation failure was considered weaning failure. Results Sixty‐three of 88 infants passed the SBT and were subsequently extubated. Of these, two (3.2%) cases rapidly developed laryngeal dyspnea imposing reintubation (excluded from analysis). Of the remaining 61 infants, 45 (73.8%) cases had successful extubation, and 16 (26.2%) cases were reintubated. Infants who failed weaning had lower gestational age, birth weight, and plasma albumin concentrations, higher NT‐proBNP, doses of surfactant, occurrence of ventilator‐associated pneumonia, and occurrence of pulmonary arterial hypertension than those who did not. NT‐proBNP was the only independent factor that could predict weaning failure (OR = 1.872; P = 0.044). The ROC‐AUC for NT‐proBNP to predict weaning failure was 0.977 (95% CI 0.918–0.997; P < 0.001). The cut‐off of NT‐proBNP level 18,500 pg/ml to predict weaning failure had a positive likelihood ratio of 25.180. The addition of NT‐proBNP to SBT in prediction of weaning failure significantly improved the net reclassification improvement (NRI = 0.224; P = 0.034). Conclusion NT‐proBNP is an independent factor that could predict weaning failure. Measurement of NT‐proBNP prior to SBT may be helpful in promoting successful ventilator weaning along with SBT. Pediatr Pulmonol. 2014; 49:757–763. © 2013 Wiley Periodicals, Inc.
Sprache
Englisch
Identifikatoren
ISSN: 8755-6863
eISSN: 1099-0496
DOI: 10.1002/ppul.22875
Titel-ID: cdi_proquest_miscellaneous_1547831695
Format
–
Schlagworte
Babies
,
Female
,
Hematocrit
,
Humans
,
Hypertension, Pulmonary - blood
,
Infant, Low Birth Weight
,
Infant, Newborn
,
Infant, Premature
,
Infant, Very Low Birth Weight
,
Male
,
mechanical ventilation (MV)
,
N-terminal pro-B-type natriuretic peptide (NT-proBNP)
,
Natriuretic Peptide, Brain - blood
,
Peptide Fragments - blood
,
Pneumonia, Ventilator-Associated - blood
,
Potassium - blood
,
Premature birth
,
Prognosis
,
Respiratory distress syndrome
,
Respiratory Distress Syndrome, Newborn - blood
,
Respiratory Distress Syndrome, Newborn - therapy
,
Serum Albumin
,
Sodium - blood
,
spontaneous breathing trial (SBT)
,
Ventilator Weaning
,
Ventilators
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