Publication: N-terminal-pro-brain natriuretic peptide: A guide for early targeted indomethacin therapy for patent ductus arteriosus in preterm Infants
1
Issued Date
2011-09-01
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ISSN
16512227
08035253
08035253
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2-s2.0-80051888538
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Mahidol University
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SCOPUS
Bibliographic Citation
Acta Paediatrica, International Journal of Paediatrics. Vol.100, No.9 (2011), 1217-1221
Suggested Citation
Pracha Nuntnarumit, Prapaiporn Chongkongkiat, Anant Khositseth N-terminal-pro-brain natriuretic peptide: A guide for early targeted indomethacin therapy for patent ductus arteriosus in preterm Infants. Acta Paediatrica, International Journal of Paediatrics. Vol.100, No.9 (2011), 1217-1221. doi:10.1111/j.1651-2227.2011.02304.x Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/12341
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Title
N-terminal-pro-brain natriuretic peptide: A guide for early targeted indomethacin therapy for patent ductus arteriosus in preterm Infants
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Abstract
Aim: To determine whether N-terminal-pro-brain natriuretic peptide (NT-proBNP) level could be an effective guide for early targeted indomethacin therapy for patent ductus arteriosus (PDA) in preterm infants. Methods: An interventional study involved preterm infants, born at < 33 weeks of gestation, who had plasma NT-proBNP levels obtained at day 2 of life. Indomethacin therapy was given if plasma NT-proBNP level was ≥10 180 pg/mL, the cut-off for predicting hemodynamic significant PDA (hsPDA). Echocardiograms were performed within 6 h at the time of plasma NT-proBNP collection and again at day 7, or whenever clinical hsPDA was suspected. Primary outcomes were the incidence of later hsPDA and unnecessary exposure rate to indomethacin. Results: Fifty infants were enrolled. On day 2, 19 (38%) infants had plasma NT-proBNP above the cut-off and received indomethacin therapy; none of them developed later hsPDA, while 1 of 31 infants with NT-proBNP below the cut-off level developed clinical hsPDA. Unnecessary exposure to indomethacin occurred in two infants (11%). Overall, no enrolled infants had either reopening of ductus or PDA ligation. Conclusion: Using NT-proBNP level on day 2 as a guide for early targeted indomethacin therapy reduced later onset of hsPDA and the number of unnecessary exposures to indomethacin. © 2011 The Author(s)/Acta Pædiatrica © 2011 Foundation Acta Pædiatrica.