Archives of Disease in Childhood - Fetal and Neonatal Edition 2009;94:F178-F182
ORIGINAL ARTICLES
B-type natriuretic peptide concentrations to guide treatment of patent ductus arteriosus
1 Department of Paediatrics, Division of Neonatology, University of Virginia, Charlottesville, Virginia, USA
2 Department of Paediatrics, Division of Paediatric Cardiology, University of Virginia, Charlottesville, Virginia, USA
Dr J T Attridge, Box 800386, Charlottesville, VA 22908, USA; ja5u{at}virginia.edu
Objective: To determine whether b-type natriuretic peptide (BNP) concentrations can guide treatment of patent ductus arteriosus (PDA) to reduce the number of indomethacin doses without increasing morbidity.
Design: Prospective, randomised, controlled trial.
Setting: Single-centre referral neonatal intensive care unit.
Patients: Infants with echocardiographic diagnosis of PDA. Infants with congenital heart disease or renal insufficiency were excluded.
Interventions: BNP measurement and echocardiography were performed in all subjects before and after indomethacin treatment. The investigational group had BNP concentrations measured 12 and 24 h after the first dose (before the 2nd and 3rd doses of indomethacin). Indomethacin dosing was withheld in the BNP-guided group if the 12 or 24 h BNP concentrations were found to be <100 pg/ml.
Main outcome measures: Number of doses of indomethacin given during the primary course of treatment (three doses every 12 h).
Results: Sixty patients were randomly assigned to control (n = 30) and BNP-guided (n = 30) treatment groups. There was no difference between the groups with respect to gestational age (26+3 vs 25+5 weeks, respectively), Apgar scores, delivery method, gender or indomethacin prophylaxis. Median baseline and 48 h BNP concentrations did not differ between the groups (0 h: 500 vs 542 pg/ml; 48 h: 85 vs 126 pg/ml; control and BNP-guided groups, respectively). During primary indomethacin treatment, the BNP-guided group received fewer doses of indomethacin than controls (70 vs 88 doses, p<0.05). The rate of PDA ligation, intestinal perforation and chronic lung disease did not differ between groups.
Conclusions: BNP-guided treatment reduced the number of primary indomethacin doses. There was no increase in PDA persistence or associated morbidity.
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
Relevant Article
- Fantoms
- Ben Stenson
Arch. Dis. Child. Fetal Neonatal Ed. 2009 94: F157.[Extract] [Full Text] [PDF]
- Full Text
- Full Text (PDF)
-
All Versions of this Article:
adc.2008.147587v1
94/3/F178 most recent - Submit a response
- Alert me when this article is cited
- Alert me when eLetters are posted
- Alert me if a correction is posted
- Citation Map
Services
- Email this link to a friend
- Similar articles in ADC Online
- Similar articles in PubMed
- Add article to my folders
- Download to citation manager
- Request Permissions
Citing Articles
Google Scholar
PubMed
Topic Collections
-
Echocardiography
-
Clinical diagnostic tests
-
Radiology (diagnostics)
-
Radiology
-
Epidemiologic studies
- Relevant Article
Bookmark with
Register for free content
The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.
Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.
