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B-type natriuretic peptide: prognostic marker in congenital diaphragmatic hernia.
[congenital diaphragmatic hernia]
B-
type
natriuretic
peptide
(
BNP
)
has
not
been
evaluated
in
newborns
with
congenital
diaphragmatic
hernia
(
CDH
)
.
We
hypothesized
that
BNP
and
severity
of
pulmonary
hypertension
(
PH
)
would
predict
clinical
outcome
in
these
infants
.
We
measured
BNP
levels
and
assessed
severity
of
PH
by
echocardiography
at
1
d
and
1
 
wk
of
life
.
Outcome
was
classified
by
status
at
56
d
(
or
prior
discharge
)
:
Good
(
n
=
13
)
if
alive
on
room
air
and
Poor
(
n
=
14
)
if
expired
or
receiving
respiratory
support
.
We
estimated
area
under
the
curve
(
AUC
)
and
95
%
confidence
interval
(
CI
)
.
BNP
levels
were
higher
at
1
d
in
newborns
with
Poor
outcome
(
median
220
pg
/
ml
vs
.
55
pg
/
ml
,
P
<
0
.
01
)
.
At
1
 
wk
,
there
was
no
significant
difference
in
BNP
level
(
median
547
pg
/
ml
vs
.
364
pg
/
ml
,
P
=
0
.
70
,
for
Poor
and
Good
outcomes
)
.
At
1
d
,
BNP
level
predicted
outcome
(
AUC
=
0
.
91
,
95
%
CI
=
0
.
77
-
1
.
0
)
,
but
this
relationship
dissipated
by
1
 
wk
(
AUC
=
0
.
55
,
95
%
CI
=
0
.
31
-
0
.
79
)
.
Severity
of
PH
did
not
predict
outcome
at
1
d
(
AUC
=
0
.
51
,
95
%
CI
=
0
.
27
-
0
.
74
)
,
but
prediction
improved
at
1
 
wk
(
AUC
=
0
.
80
,
95
%
CI
=
0
.
61
-
0
.
99
)
.
BNP
is
a
strong
predictor
of
clinical
outcome
in
newborns
with
CDH
at
1
d
of
life
.
Diseases
Validation
Diseases presenting
"poor outcome"
symptom
congenital diaphragmatic hernia
dedifferentiated liposarcoma
esophageal carcinoma
junctional epidermolysis bullosa
krabbe disease
liposarcoma
omenn syndrome
pyomyositis
systemic capillary leak syndrome
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