Persistent Pulmonary Hypertension of Newborn Clinical Trial
Official title:
Clinical Significance of N-Terminal Pro-Brain Natriuretic Peptide Levels in Persistent Pulmonary Hypertension
Babies who are suspected of having persistent pulmonary hypertension (PPHN) will be included in this study. PPHN is a condition in which the blood is restricted from flowing to the lungs in a normal way making it hard for babies to breath and placing strain on the heart. This study will observe whether certain hormones that measure stress (N-terminal pro-brain natriuretic peptide) can help determine how well a baby will do when they have PPHN.
PPHN occurs in infant > or = 34 weeks gestation and is characterized by an elevation in
pulmonary vascular resistance (PVR) and right-to-left shunting of the blood at the atrial,
ductal, and pulmonary levels, leading to hypoxemia. Management of these infants is complex
(and the clinical course) is often difficult to predict.
Brain natriuretic peptide (BNP) is a cardiac hormone that is secreted from cardiac myocytes
and cardiac fibroblasts. Upon activation, the prohormone is cleaved into a biologically
active BNP and an inactive N-terminal proBNP (NT-proBNP). BNP and NT-proBNP levels are
increasingly being used for diagnostic purpose in adults and have been correlated to adult
pulmonary hypertension. Multiples studies have been performed to determine normal values for
NT-proBNP in the pediatric population. One study measured NT-proBNP levels in umbilical cord
blood during the second trimester and at delivery of uncomplicated pregnancies and
determined normal reference values of NT-proBNP. It is thought that NT-proBNP has potential
for use in term infants with PPHN.
The objective of this research is to correlate NT-proBNP levels to left ventricular
dysfunction in term infants with PPHN. Secondarily, we want to assess the possible use of
NT-proBNP to predict response to inhaled nitric oxide and the ability to successfully wean
off inhaled nitric oxide.
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Observational Model: Cohort, Time Perspective: Prospective
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