Prognostic and Predictive Value of Serum b-Type Natriuretic Peptide in Early Mortality and Morbidity of Children with Congenital Heart Disease after Open Heart Surgery

Arafa, R.S.; Azab, S.E.; Sheta, S.S.; Kamal, H.M.; Nassar, M.S.

doi:10.21608/bjas.2020.136104

Prognostic and Predictive Value of Serum b-Type Natriuretic Peptide in Early Mortality and Morbidity of Children with Congenital Heart Disease after Open Heart Surgery

Document Type : Original Research Papers

Authors

¹ Pediatrics Dept., Faculty of Medicine, Benha Univ., Benha, Egypt

² Cardio thorathic surgery Dept., Faculty of Medicine, Benha Univ., Benha, Egypt

³ Clinical and Chemical Dept., Faculty of Medicine, Benha Univ., Benha, Egypt

10.21608/bjas.2020.136104

Abstract

Epilepsy is a common neurodegenerative disease with an increasing morbidity. Clinical treatment of epilepsy includes symptomatic treatment, etiological treatment, surgery and prevention. The aim of the present study was to determine the effects of antiepileptic drugs (AEDs) on serum folate and vitamin B12 in various epileptic patients. Brain type natriuretic peptide (BNP) is a cardiac hormone that is secreted mainly by the ventricles in response to volume expansion and pressure load. It can predict post-operative complications after open cardiac surgery in children. We sought to evaluate the prognostic and predictive values of proBNP in children after heart surgery.This study was a prospective observational study conducted on patients with congenital heart diseases admitted to the pediatric cardiology department in Cairo University Children Hospital and Atfal Maser Hospital during 2 years interval from February 2016 to March 2018.The study was conducted on 45 cases age range from 0 up to 12 years, who are previously listed and prepared for open heart surgery. Brain natriuretic peptides determinations might be a useful tool for clinicians caring for infants and children after surgical intervention for congenital heart disease. The aim of this study is to compare perioperative changes in plasma brain natriuretic peptides in children undergoing open heart surgery and to evaluate effect of cardiopulmonary bypass on proBNP levels.The results in the present study revealed preoperative BNP assay of the 45 cases with a mean 239.6 +/- 829.7 pg/ml (median =32.0 pg/ml) and postoperative BNP assay with a mean 1412.2 +/-1279.1 pg/ml.In the current study, a comparison between preoperative and postoperative BNP values was done and revealed the total mean difference between pre and postoperative BNP was with a mean 1,172.5838 pg/ml +/- 936.6379 pg/ml with a significant p-value (0.00). We have found many studies in agreement with the results in the current study which have showed increase in BNP levels after surgery. ProBrain natriuretic peptides determinations might be a useful tool for clinicians caring for infants and children after surgical intervention for congenital heart disease. Mechanical ventilation duration, inotropic score calculation as well as Core-peripheral temperature difference are of value when correlated to postoperative BNP measurements. ProBNP cut off values in predicting poor outcome are of paramount importance.