Key result
Elevated preoperative pro-atrial natriuretic peptide (proANP) was independently associated with an increased need for respiratory support after pediatric cardiac surgery (OR 3.575).
Why the study?
Children may require increased intensive care support and develop complications after cardiac surgery, prompting evaluation of preoperative proANP and proADM to predict postoperative respiratory or inotropic needs.
Do pre-operative proANP and proADM levels predict the need for increased respiratory or inotropic support after pediatric cardiac surgery?
Observational (n=113)
No
Do pre-operative proANP and proADM levels predict the need for increased respiratory or inotropic support after pediatric cardiac surgery?
Odds Ratio: 3.575 (95% CI 1.684–7.591)
p-value: p=0.001
Elevated pre-operative proANP levels can independently predict the need for increased respiratory and inotropic support in children undergoing cardiac surgery.
May support preoperative risk stratification for respiratory needs in pediatric cardiac surgery; leaves open utility pending prospective validation.
INTRODUCTION AND OBJECTIVE: Pro-atrial natriuretic peptide (proANP) and pro-adrenomedullin (proADM) levels increase in acute heart failure and sepsis. After cardiac surgery, children may require increased support in the intensive care unit and may develop complications. The aim of this study was to evaluate the utility of proANP and proADM values, determined prior to cardiac surgery, for predicting the need for increased respiratory or inotropic support during the post-operative period. METHODS: This was a prospective study in children. Biomarkers were analyzed before surgery using a single blood test. The primary endpoints were the need for greater respiratory and/or inotropic support during the post-operative period. Secondary endpoints were the relationship between these biomarkers and complications after surgery. RESULTS: One hundred thirteen patients were included. ProANP and proADM were higher in children who required greater respiratory and inotropic support, especially proANP; for increased respiratory support, 578.9 vs. 106.6 pmol/L (p = 0.004), and for increased inotropic support, 1938 vs. 110.4 pmol/L (p = 0.002). ProANP had a greater AUC than proADM for predicting increased respiratory support after surgery: 0.791 vs. 0.724. A possible cut-off point for proANP could be ≥ 325 pmol/L (sensitivity = 66.7% and specificity = 88.8%). In the multivariate analysis, the logarithmic transformation of proANP was independently associated with the need for increased respiratory support (OR = 3.575). Patients who presented a poor outcome after cardiac surgery also had higher biomarker values (proADM, p = 0.013; proANP, p = 0.001). CONCLUSIONS: Elevated proANP before cardiac surgery may identify which children will need more respiratory and inotropic support during the post-operative period.
No takes yet. Share an insight, caveat, or question.
Bobillo‐Pérez et al. (2020) conducted an observational in Pediatric cardiac surgery (n=113). Preoperative pro-atrial natriuretic peptide (proANP) vs. Lower preoperative proANP levels was evaluated on Need for increased respiratory support (>72 hours of mechanical ventilation) (OR 3.575, 95% CI 1.684-7.591, p=0.001). Elevated preoperative pro-atrial natriuretic peptide (proANP) was independently associated with an increased need for respiratory support after pediatric cardiac surgery (OR 3.575).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: