rss
Arch Dis Child Fetal Neonatal Ed 93:F407-F412 doi:10.1136/adc.2007.133140
  • Original article

Biochemical markers may identify preterm infants with a patent ductus arteriosus at high risk of death or severe intraventricular haemorrhage

  1. A El-Khuffash1,
  2. D Barry1,
  3. K Walsh2,
  4. P G Davis3,
  5. E J Molloy1,2
  1. 1
    Department of Neonatology, National Maternity Hospital, Dublin, Ireland
  2. 2
    Department of Paediatric Cardiology, Our Lady’s Children Hospital, Crumlin, Ireland
  3. 3
    Neonatal Services, Royal Women’s Hospital, Carlton, Victoria, Australia
  1. Afif El-Khuffash, National Maternity Hospital, Holles Street, Dublin 2, Ireland; afif_faisal{at}hotmail.com
  • Accepted 5 February 2008
  • Published Online First 19 February 2008

Abstract

Background: A patent ductus arteriosus (PDA) in preterm infants is associated with increased risk of intraventricular haemorrhage (IVH) and death. Cardiac troponin T (cTnT) and N-terminal-pro-B type natriuretic peptide (NTpBNP) are markers of cardiac function and can predict poor outcome in adults.

Aims: To determine whether echocardiography and cTnT/NTpBNP levels at 48 h predict death before discharge or severe IVH in preterm infants with a PDA.

Methods: Infants born <32 weeks' gestation or <1500 g underwent echocardiographic and cTnT/NTpBNP measurements at 12 and 48 h of life. Infants were divided according to their status at discharge: a closed PDA at 48 h, infants with a PDA at 48 h and IVH III/IV and/or death, and infants with a PDA at 48 h without IVH III/IV or death.

Results: Eighty infants with a median gestation of 28 weeks (IQR 26.1–29.5) and birth weight 1.06 kg (0.8–1.21) were included. At 48 h, infants with a PDA and IVH III/IV and/or death had significantly higher median cTnT/NTpBNP levels compared to infants with a PDA without IVH III/IV and/or death and those with spontaneous PDA closure (NTpBNP 9282, 5121 and 740 pmol/l, respectively, p = 0.008, and cTnT 0.66, 0.25 and 0.13 µg/l, respectively, p = 0.027). There were no differences in echocardiographic parameters of PDA size, left atrial to aortic ratio (LA:Ao), left and right ventricular outputs between the PDA groups.

Conclusions: NTpBNP and cTnT in conjunction with echocardiography may provide a basis for trials of targeted medical treatment in infants with a PDA.

Footnotes

  • Competing interests: None.

  • Funding: National Maternity Hospital Research Fund.

  • Ethics approval: The study was approved prior to commencement by the National Maternity Hospital’s Ethics Committee, Dublin, Ireland.

  • Patient consent: Informed parental consent was requested within the first 24 h of life.

Latest from Education & Practice

Latest from Education & Practice

Register for free content

Free sample
This recent issue is free to all users to allow everyone the opportunity to see the full scope and typical content of ADC Fetal & Neonatal.
View free sample issue >>

Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.

Navigate This Article