Diagnostic Accuracy of NT-ProBNP for Heart Failure with Sepsis in Patients Younger than 18 Years

PLoS One. 2016 Jan 26;11(1):e0147930. doi: 10.1371/journal.pone.0147930. eCollection 2016.

Abstract

This clinical study investigated plasma NT-proBNP levels as a potential predictor of heart failure in pediatric patients with sepsis. Plasma NT-ProBNP levels of 211 pediatric patients with sepsis and 126 healthy children were measured. Patients were stratified as with heart failure (HF) or without heart failure (non-HF). Patients were graded as having sepsis, severe sepsis, or septic shock. The optimal cut-off values of plasma NT-ProBNP for heart failure were determined by analyzing the receiver operating characteristic (ROC). In the HF, non-HF and control groups, the median plasma NT-proBNP levels were 3640, 656, and 226 ng/L, respectively. For all patients with sepsis, the optimal diagnostic cut-off value was 1268 ng/L for differentiating heart failure. In the severe sepsis patients and septic shock patients, the optimal diagnostic cut-off values were 1368 ng/L and 1525 ng/L, respectively. This report is the first one to reveal that NT-proBNP may predict heart failure in children with sepsis. It provides an important clinical reference for the diagnosis of heart failure in pediatric patients with sepsis, and enables monitoring septic children for cardiac involvement.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Area Under Curve
  • C-Reactive Protein / analysis
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Echocardiography
  • Heart Failure / blood
  • Heart Failure / complications*
  • Heart Failure / diagnosis*
  • Humans
  • Infant
  • Infant, Newborn
  • Natriuretic Peptide, Brain / analysis*
  • Peptide Fragments / analysis*
  • ROC Curve
  • Sepsis / complications*
  • Sepsis / diagnosis*
  • Sepsis / pathology
  • Severity of Illness Index
  • Spectrometry, Fluorescence

Substances

  • Peptide Fragments
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain
  • C-Reactive Protein

Grants and funding

This study was supported by the Department of Science and Technology of Guangdong Province in China (grant no. 2011B031800134) and the Bureau of Science and Technology of Foshan City in China (grant no. 201008189). These funders were not involved in the study design, or the collection, analysis, or interpretation of the data, in the writing of the report, or in the decision to submit the article for publication.