N-TERMINAL PROHORMONE OF BRAIN NATRIURETIC PEPTIDE IN THE DIAGNOSIS AND MANAGEMENT OF PERSISTENT PULMONARY HYPERTENSION IN NEWBORNS

Abstract

Objective: This study aimed to investigate the levels and utility of amino/N-terminal prohormone of brain natriuretic peptide (NT-proBNP) in the diagnosis of neonatal persistent pulmonary hypertension (PPHT). Materials and Methods: Infants born at Z34 weeks of gestation were included in this retrospective cross-sectional study. In total, 33 newborns diagnosed with PPHT were included in the patient group and 50 healthy newborns were included in the control group. Patient and control groups were compared in terms of plasma NT-proBNP levels measured in the umbilical cord (UC) and at 72 hours of life. Results: The NT-proBNP levels in UC and at 72 hours were significantly higher in neonates with PPHT compared to controls (p<0.01). For the diagnosis of PPHT, UC NT-proBNP cut-off value was >2760.5 pg/ml, sensitivity was 90.7%, and specificity was 96.6%(p<0.01). For NT-proBNP at 72 hours, the cut-off value was >1414 pg/ml, sensitivity was 95.9%, and specificity was 91.2% (p<0.01). The mean UC NT-proBNP levels were 1094.7 +/- 603 pg/ml and mean NT-proBNP levels at 72 hours were 875.7 +/- 423 pg/ml in the control group. Conclusion: NT-proBNP levels are high during the initial days of life. They are useful in the diagnosis and follow-up of PPHT in newborns with hypoxemic respiratory failure and high fraction of inspired oxygen (FiO(2)) requirement, especially in cases where transthoracic echocardiography (TTE) cannot be performed.