Ductus Arteriosus, Patent Clinical Trial
Official title:
A Study of the Value of Plasma N-terminal proBNP Concentrations for Diagnosing Patent Ductus Arteriosus in Preterm Babies.
Premature babies are affected by a condition known as "patent ductus arteriosus" in which
the ductus arteriosus (a normal structure) fails to close after birth as it should. A very
large ductus can put extra strain on the heart and lungs, making the baby's breathing
dependent on a mechanical ventilator. Attending physicians can close the duct with
medical\or surgical treatment but assessing whether this is justified can be difficult. The
physician usually bases this decision on assessment of the baby's general condition and an
ultrasound evaluation of the heart (called an "echocardiogram") but the last is particularly
dependent on availability of skilled operators.
The investigators have examined whether blood levels of a hormone called B-type natriuretic
peptide (Nt pro-BNP)in the first week of life predict the need to treat a ductus arteriosus.
This hormone is produced by the heart if it is under strain. If the test is helpful it could
reduce dependence of physicians on echocardiography by skilled operators.
Babies who were recruited had blood samples collected on days 1, 2, 3 and 7 for measurement
of Nt pro-BNP. Each baby also had an echocardiogram performed between the fifth and seventh
day of life. Decisions about treatment of the duct were made by attending physicians
independent of the study. Physicians, investigators and echocardiographers were blinded to
knowledge of the Nt pro-BNP concentration. Nt pro-BNP was also measured before and after
treatment in all babies who had a PDA treated and echocardiography performed to confirm
closure.
Receiver operating characteristics (ROC) curves were used to assess the predictive value of
Nt pro-BNP for samples collected at each time point. The investigators also compared the Nt
pro-BNP levels in samples collected before and after treatment to assess the usefulness of
Nt pr-BNP as an indicator of duct closure.
Status | Completed |
Enrollment | 102 |
Est. completion date | June 2007 |
Est. primary completion date | June 2007 |
Accepts healthy volunteers | No |
Gender | Both |
Age group | N/A and older |
Eligibility |
Inclusion Criteria: - Preterm babies under 34-weeks gestation admitted to the neonatal intensive care unit Exclusion Criteria: - Known structural heart abnormality other than PDA |
Observational Model: Cohort, Time Perspective: Prospective
Country | Name | City | State |
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n/a |
Lead Sponsor | Collaborator |
---|---|
St George's, University of London | Medical Research Council, National Health Service, United Kingdom |
Ramakrishnan S, Heung YM, Round J, Morris TP, Collinson P, Williams AF. Early N-terminal pro-brain natriuretic peptide measurements predict clinically significant ductus arteriosus in preterm infants. Acta Paediatr. 2009 Aug;98(8):1254-9. doi: 10.1111/j.1 — View Citation
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