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The frequency of postoperative BNP measurement and intervention threshold of BNP concentration in pediatric cardiac intensive care unit: a prospective multicenter observational study

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Abstract

Purpose

The purpose of this study is to investigate the current status of postoperative BNP measurement in the pediatric cardiac intensive care unit (PCICU).

Methods

This was a prospective multicenter observational study. Children under 15 years old who underwent pediatric cardiac surgery were included. Postoperatively, all BNP measurement was collected in PCICU. We checked whether each BNP measurement was used for the decision-making of intervention or not. We divided the BNP measurements into 4 groups: group A 0–299 pg/ml (reference), group B 300–999 pg/ml, group C 1000–1999 pg/ml, group D ≧ 2000 pg/ml. We performed logistic regression analysis to compare the intervention ratio between group A and B, C, D. We also did multiple comparison analyses to compare the intervention ratio in each group.

Results

Thirty-nine (15.8%) measurements were used as a criterion to intervene in all BNP measurements. There was no protocol for the measurement of BNP in all institutions. The number of BNP measurements in each group is as follows: group A 113 (45.9%), group B 81 (32.9%), group C 45 (18.3%), group D 7 (2.8%). The intervention ratio in each group was 6.2% (group A), 8.6% (group B), 44.4% (group C), and 71.4% (group D). The intervention ratio of group C and D were significantly higher than group A: (Odds ratio (95%CI): 12.1(4.8–33.9), p < 0.0001, 25.2(5.2–146.2), p < 0.0001). The result of multiple comparisons is similar to logistic regression analysis.

Conclusion

High BNP concentration, especially more than 1000 pg/ml, was more often intervened upon compared to that of less than 1000 pg/ml.

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Data Availability

Please contact author for data requests.

Abbreviations

BNP:

brain natriuretic peptide

CHD:

congenital heart disease

PCICU:

pediatric cardiac intensive care unit

CPB:

cardiopulmonary bypass

RACHS-1:

risk adjustment for congenital heart surgery version 1

IQR:

interquartile ranges

CI:

confidence interval

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Acknowledgements

There are no additional acknowledgements

Funding

TK received funding from grants-in-aid for scientific research from the Ministry of Education, Science, and Culture of Japan (MEXT/JSPS KAKENHI grant number JP26861233). This study was supported by grants-in-aid for scientific research from the Ministry of Education, Science, and Culture of Japan (MEXT/JSPSKAKENHI grant number JP26861233).

Author information

Authors and Affiliations

  1. Anesthesiology and Resuscitology, Okayama University Hospital, 2-5-1 Shikatachou, Kitaku, Okayama, 700-8525, Japan

    Tomoyuki Kanazawa, Kazuyoshi Shimizu & Tatsuo Iwasaki

  2. Jichi Children’s Medical Center Tochigi, Anesthesiology, 3311-1 Yakushiji, Utsunomiya, Tochigi, Japan

    Naoyuki Taga

  3. Kyoto Prefectural University of Medicine Hospital, Anesthesiology, 465 Kaji-cho, Kamigyo-ku, Kyoto, Japan

    Masaki Yamasaki

  4. Shimane University Hospital, Anesthesiology, 89-1 Shioji-cho, Izumo-shi, Shimane, Japan

    Hideaki Mori

  5. Ehime University Hospital, Anesthesiology, 454 Shizugawa, Toon, Ehime, Japan

    Sonoko Fujii

Authors
  1. Tomoyuki Kanazawa
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  2. Kazuyoshi Shimizu
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  3. Naoyuki Taga
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  4. Masaki Yamasaki
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  5. Hideaki Mori
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  6. Sonoko Fujii
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  7. Tatsuo Iwasaki
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Contributions

TK, TI and KS: participated in the design of the study. TK, NT, KO, MY, and SF: collected data and performed the statistical analysis. TK: wrote the manuscript. NT, KO, MY, SF, TI and KS: revised and edited the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Tomoyuki Kanazawa.

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Conflict of interest

The authors declare that they have no competing interests.

Ethical approval

Okayama University Hospital Institutional Review Board waived the need for obtaining informed consent and approved this study and its submission for publication (No 1507–020). If you have any question, please contact the following address.

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Kanazawa, T., Shimizu, K., Taga, N. et al. The frequency of postoperative BNP measurement and intervention threshold of BNP concentration in pediatric cardiac intensive care unit: a prospective multicenter observational study. J Anesth 36, 367–373 (2022). https://doi.org/10.1007/s00540-022-03052-9

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  • DOI: https://doi.org/10.1007/s00540-022-03052-9

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