Application of NT-proBNP in ventilator weaning for preterm infants with RDS

Autor: Li Wang, Qin Zhang, Hong Xiang Guo, Cheng Han Luo, Qian Ya Xu, Xiu Yong Cheng, Zan Yang Shi, Shanshan Zhang, Guang Yao Sheng, Qian Zhang, Xin Ru Cheng
Rok vydání: 2013
Předmět:
Zdroj: Pediatric Pulmonology. 49:757-763
ISSN: 8755-6863
DOI: 10.1002/ppul.22875
Popis: 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
Databáze: OpenAIRE
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