Troponin T, N-terminal pro natriuretic peptide and a patent ductus arteriosus scoring system predict death before discharge or neurodevelopmental outcome at 2 years in preterm infants

Afif F El-Khuffash; Marie Slevin; Patrick J McNamara; Eleanor J Molloy

doi:10.1136/adc.2010.185967

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Troponin T, N-terminal pro natriuretic peptide and a patent ductus arteriosus scoring system predict death before discharge or neurodevelopmental outcome at 2 years in preterm infants

Journal article

Peer reviewed

Troponin T, N-terminal pro natriuretic peptide and a patent ductus arteriosus scoring system predict death before discharge or neurodevelopmental outcome at 2 years in preterm infants

Afif F El-Khuffash, Marie Slevin, Patrick J McNamara and Eleanor J Molloy

Archives of disease in childhood. Fetal and neonatal edition, Vol.96(2), pp.F133-F137

03/2011

DOI: 10.1136/adc.2010.185967

PMID: 21071684

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Abstract

There is little consensus regarding the use of echocardiography in patent ductus arteriosus (PDA) treatment in preterm infants. The use of troponin T (cTnT) and N-terminal Pro-BNP (NTpBNP) in combination with echocardiography assessment may facilitate the development of a superior predictive model. To investigate the ability of cTnT, NTpBNP and a PDA scoring system applied at 48 h of life to predict death before discharge and neurodevelopmental outcome at 2 years of age. Infants <32 weeks and <1500 g were prospectively enrolled. Echocardiography evaluation coupled with cTnT and NTpBNP measurements were done at 48 h. The ductus arteriosus was scored (0-6) according to echocardiography markers of haemodynamic significance. Infants were assessed at 2 years using the Bayley scales and categorised into two groups: Severe Disability/Death before discharge or Normal/Mild Disability. Sixty infants with a median gestation of 27.7 weeks (26.2-29.4) and a median birth weight of 1.01 kg (0.86-1.22) were followed up to 2 years of age. Plasma cTnT and NTpBNP were higher in the Severe Disability/Death compared to the Normal/Mild Disability group (2.30 μg/l vs 0.19 μg/l, p<0.001; 9209 pmol/l vs 1664 pmol/l, p<0.001, respectively). The severe group had a higher PDA score compared to the mild and normal groups (5 vs 2, p<0.001). Blood cTnT, NTpBNP and a PDA scoring system at 48 h may facilitate the identification of those infants with a PDA, who are at greatest risk of poor neurodevelopmental outcome at 2 years of age.

Disability Evaluation

Infant, Premature, Diseases - psychology

Prognosis

Developmental Disabilities - etiology

Humans

Male

Biomarkers - blood

Infant, Premature, Diseases - blood

Gestational Age

Birth Weight

Troponin T - blood

Ductus Arteriosus, Patent - blood

Epidemiologic Methods

Ductus Arteriosus, Patent - psychology

Infant, Premature

Peptide Fragments - blood

Ultrasonography

Female

Ductus Arteriosus, Patent - diagnostic imaging

Infant, Newborn

Natriuretic Peptide, Brain - blood

Details

Title: Subtitle: Troponin T, N-terminal pro natriuretic peptide and a patent ductus arteriosus scoring system predict death before discharge or neurodevelopmental outcome at 2 years in preterm infants
Creators: Afif F El-Khuffash - Department of Neonatology, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada. afif_faisal@hotmail.com
Marie Slevin
Patrick J McNamara
Eleanor J Molloy
Resource Type: Journal article
Publication Details: Archives of disease in childhood. Fetal and neonatal edition, Vol.96(2), pp.F133-F137
DOI: 10.1136/adc.2010.185967
PMID: 21071684
ISSN: 1359-2998
eISSN: 1468-2052
Language: English
Date published: 03/2011
Academic Unit: Stead Family Department of Pediatrics; Neonatology; Internal Medicine
Record Identifier: 9984093461802771

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