Key result
B-type natriuretic peptide and troponin measurements may be beneficial in evaluating hemodynamics and postoperative outcomes in pediatric cardiac patients, though conclusive evidence is lacking.
Why the study?
Does the measurement of B-type natriuretic peptide and troponin predict postoperative mortality and complications in cardiac intensive care patients?
Does the measurement of B-type natriuretic peptide and troponin predict postoperative mortality and complications in cardiac intensive care patients?
While BNP and troponin can predict postoperative mortality and complications in cardiac ICU patients, there is currently insufficient evidence to use them to guide inpatient management in pediatric cardiac disease.
Answers are grounded in this paper and cite their sources.
Insufficient evidence precludes routine BNP/troponin use to guide pediatric cardiac ICU management; leaves open predictive utility pending prospective validation.
Serum biomarkers, such as B-type natriuretic peptide and troponin, are frequently measured in the cardiac intensive care unit. A review of the evidence supporting monitoring of these biomarkers is presented. DESIGN: A search of MEDLINE, PubMed, and the Cochrane Database was conducted to find literature regarding the use of B-type natriuretic peptide and troponin in the cardiac intensive care setting. Adult and pediatric data were considered. RESULTS AND CONCLUSION: Both B-type natriuretic peptide and troponin have demonstrated utility in the intensive care setting but there is no conclusive evidence at this time that either biomarker can be used to guide inpatient management of children with cardiac disease. Although B-type natriuretic peptide and troponin concentrations can alert clinicians to myocardial stress, injury, or hemodynamic alterations, the levels can also be elevated in a variety of clinical scenarios, including sepsis. Observational studies have demonstrated that perioperative measurement of these biomarkers can predict postoperative mortality and complications. RECOMMENDATION AND LEVEL OF EVIDENCE: (class IIb, level of evidence B): The use of B-type natriuretic peptide and/or troponin measurements in the evaluation of hemodynamics and postoperative outcome in pediatric cardiac patients may be beneficial.
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Domico et al. (2011) conducted a review in Cardiac disease in the intensive care setting. B-type natriuretic peptide and troponin monitoring was evaluated. B-type natriuretic peptide and troponin measurements may be beneficial in evaluating hemodynamics and postoperative outcomes in pediatric cardiac patients, though conclusive evidence is lacking.
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