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
- 1Department of Neonatology, Hospital for Sick Children, Toronto, Ontario, Canada
- 2UCD School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland
- 3Department of Neonatology, National Maternity Hospital, Dublin, Ireland
- 4Royal College of Surgeons of Ireland, Dublin, Ireland
- Correspondence to Afif EL-Khuffash, Department of Neonatology, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada, M5G 1X8;
- Accepted 13 September 2010
- Published Online First 11 November 2010
Background 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.
Objective 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.
Design/Methods 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.
Results 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).
Conclusion 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.
Funding Funded by the National Maternity Hospital Research Fund.
Competing interests None.
Ethics approval This study was conducted with the approval of the National Maternity Hospital Ethics Committee.
Provenance and peer review Not commissioned; externally peer reviewed.