NT-Pro-BNP and echocardiography for the early assessment of cardiovascular dysfunction in neonates with sepsis.

Chunyan Yang, Jing Ma, Lei Guo, Baoyun Li, Lina Wang, Meixue Li, Ting Wang, Ping Xu, Cuifen Zhao

Medicine 2022 Sep 16

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To investigate the predictive manner of N-terminal fragment of brain natriuretic peptide (NT-Pro-BNP) and echocardiography in the early assessment of cardiovascular dysfunction (CVD) in neonates with sepsis, we recruited 108 neonates with sepsis in intensive care units and divided them into a sepsis with CVD (sepsis + CVD) group (n = 48) and a sepsis only group (n = 60). Neonates with other infections (n = 65) constituted the control group. Clinical, laboratory, and bedside echocardiography findings were evaluated. Compared to both the sepsis only and control groups, the sepsis + CVD group showed an earlier onset of symptoms [52.94 (0-185.6) h], higher NT-Pro-BNP levels (P = .02), a higher Tei index (0.52 + 0.03; P = .03), and lower ejection fraction (62.61% ± 12.31%, P < .05). Compared to the control group, the sepsis + CVD group exhibited hematogenous etiology (P < .05), lower albumin (ALB) levels (P = .04), lower white blood cell counts (P = .03), a higher high-sensitivity C-reactive protein/ALB ratio, and a larger right-ventricle-inner diameter (10.74 + 2.42 mm; P = .01). CVD in the septic neonates could be predicted by either NT-Pro-BNP levels (cut-off: 12,291.5 pg/L; sensitivity, 80%; specificity, 79%; area under the curve-receiver operating characteristic, 0.81) or Tei index (cut-off: 0.45; sensitivity, 74%; specificity, 77%; area under the curve-receiver operating characteristic, 0.78). NT-Pro-BNP levels and echocardiography can be used to determine early onset of CVD in neonatal sepsis, which facilitates timely pharmacological interventions and treatment. Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

Citation

Chunyan Yang, Jing Ma, Lei Guo, Baoyun Li, Lina Wang, Meixue Li, Ting Wang, Ping Xu, Cuifen Zhao. NT-Pro-BNP and echocardiography for the early assessment of cardiovascular dysfunction in neonates with sepsis. Medicine. 2022 Sep 16;101(37):e30439