TY - JOUR
T1 - Perioperative Brain Natriuretic Peptide in Pediatric Cardiac Surgery Patients
T2 - Its Association With Postoperative Outcomes
AU - Kanazawa, Tomoyuki
AU - Egi, Moritoki
AU - Toda, Yuichiro
AU - Shimizu, Kazuyoshi
AU - Sugimoto, Kentarou
AU - Iwasaki, Tatsuo
AU - Morimatsu, Hiroshi
N1 - Publisher Copyright:
© 2017 Elsevier Inc.
Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2017/4
Y1 - 2017/4
N2 - Objectives The aim of this study was to investigate the relationship between perioperative brain natriuretic peptide levels and the incidence of postoperative serious adverse events (SAEs) in pediatric cardiac patients. Design A prospective observational study. Setting A single-institution university hospital. Participants Children under 15 years old who underwent cardiac surgery that required cardiopulmonary bypass from December 21, 2012 to February 26, 2014. The Risk Adjustment for Congenital Heart Surgery 1 category less than 1 was excluded. Interventions Brain natriuretic peptide (BNP) levels were measured preoperatively (BNPpre) and on postoperative day 1 (BNPPOD1) and postoperative day 3 (BNPPOD3). Methods and Results Primary outcome was the incidence of postoperative SAEs; (1) death in the intensive care unit, (2) requirement of extracorporeal membrane oxygenation, (3) cardiac arrest, and (4) requirement of reoperation for hemodynamic instability. The authors included 71 patients in this study. There were 8 patients (11%) who had at least 1 SAE. Median preoperative BNP level in patients with SAEs was significantly higher than in those without SAEs (1,541 pg/mL [IQR: 121-5,962] v 122 pg/mL [QR: 34-342], p = 0.01). From the receiver operating characteristic curve of BNPpre for the incidence of SAEs, an area under the curve was 0.77 (95%CI 0.55-0.91). The best cutoff BNPpre number was 1,000 pg/mL. From the multivariate logistic regression model, BNPpre>1,000 pg/mL was associated independently with risk of SAEs (adjusted odds ratio = 8.5, 95% CI [1.3, 59.3], p = 0.02). Conclusions In conclusion, the authors’ study showed that increased preoperative brain natriuretic peptide concentration, especially a concentration of more than 1,000 pg/mL, was associated with risk of SAEs in pediatric cardiac surgery patients.
AB - Objectives The aim of this study was to investigate the relationship between perioperative brain natriuretic peptide levels and the incidence of postoperative serious adverse events (SAEs) in pediatric cardiac patients. Design A prospective observational study. Setting A single-institution university hospital. Participants Children under 15 years old who underwent cardiac surgery that required cardiopulmonary bypass from December 21, 2012 to February 26, 2014. The Risk Adjustment for Congenital Heart Surgery 1 category less than 1 was excluded. Interventions Brain natriuretic peptide (BNP) levels were measured preoperatively (BNPpre) and on postoperative day 1 (BNPPOD1) and postoperative day 3 (BNPPOD3). Methods and Results Primary outcome was the incidence of postoperative SAEs; (1) death in the intensive care unit, (2) requirement of extracorporeal membrane oxygenation, (3) cardiac arrest, and (4) requirement of reoperation for hemodynamic instability. The authors included 71 patients in this study. There were 8 patients (11%) who had at least 1 SAE. Median preoperative BNP level in patients with SAEs was significantly higher than in those without SAEs (1,541 pg/mL [IQR: 121-5,962] v 122 pg/mL [QR: 34-342], p = 0.01). From the receiver operating characteristic curve of BNPpre for the incidence of SAEs, an area under the curve was 0.77 (95%CI 0.55-0.91). The best cutoff BNPpre number was 1,000 pg/mL. From the multivariate logistic regression model, BNPpre>1,000 pg/mL was associated independently with risk of SAEs (adjusted odds ratio = 8.5, 95% CI [1.3, 59.3], p = 0.02). Conclusions In conclusion, the authors’ study showed that increased preoperative brain natriuretic peptide concentration, especially a concentration of more than 1,000 pg/mL, was associated with risk of SAEs in pediatric cardiac surgery patients.
KW - brain natriuretic peptide
KW - pediatric cardiac surgery patients
KW - serious adverse events
UR - http://www.scopus.com/inward/record.url?scp=85007478312&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85007478312&partnerID=8YFLogxK
U2 - 10.1053/j.jvca.2016.09.008
DO - 10.1053/j.jvca.2016.09.008
M3 - Article
C2 - 27919715
AN - SCOPUS:85007478312
VL - 31
SP - 537
EP - 542
JO - Journal of Cardiothoracic and Vascular Anesthesia
JF - Journal of Cardiothoracic and Vascular Anesthesia
SN - 1053-0770
IS - 2
ER -