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Clinical utility of B‐type natriuretic peptide ( NP ) in pediatric cardiac surgery – a systematic review
Author(s) -
Afshani Nura,
Schülein Simone,
Biccard Bruce M.,
Thomas Jenny M.
Publication year - 2015
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1111/pan.12467
Subject(s) - medicine , perioperative , cardiopulmonary bypass , cardiac surgery , natriuretic peptide , heart disease , mechanical ventilation , biomarker , intensive care unit , disease , population , heart failure , brain natriuretic peptide , intensive care medicine , cardiology , surgery , biochemistry , chemistry , environmental health
Summary Background NP is a biomarker that has been used in the diagnosis, management, and prognostication of a number of cardiovascular disorders in the pediatric population. The physiological role of this hormone is to allow the myocardium to adapt to stress or strain imposed by a volume and/or pressure load. Objective The aim of this study was to determine the utility of preoperative and postoperative NP to predict outcome in pediatric patients undergoing cardiac surgery for structural congenital heart disease. Method We conducted a systematic review by searching three electronic databases using the search terms ‘paediatric’ or ‘pediatric’ and ‘B‐type natriuretic peptide’. Twenty peer‐reviewed papers were included in the study. Results Preoperative NP levels were associated with the severity of cardiac failure in several studies. Preoperative NP s also correlated with early postoperative outcome measures such as duration of cardiopulmonary bypass, duration of mechanical ventilation, presence of low cardiac output syndrome, length of stay in the intensive care unit and in one study, death. Early (within 24 h) postoperative NP s showed a stronger correlation than preoperative NP s to early postoperative adverse events. Conclusion NP s provide a simple, noninvasive and complementary tool to echocardiography that can be used to assist clinicians in the assessment and management of pediatric patients with congenital heart disease in the perioperative period.