{"title":"NT-proBNP plasma levels as early predictor of ventilatory support in bronchiolitis: A prospective analysis.","authors":"Zayani Seyfeddine, Thabet Farah, Daya Abir, Benabdallah Imen, Mkaouer Wejdenne, Chouchane Chokri, Neffati Fadoua, Chouchane Slaheddine","doi":"10.1016/j.arcped.2025.06.006","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the role of serum NT-proBNP (N-Terminal Pro Brain Natriuretic Peptide) levels as an early predictor of ventilatory support in infants hospitalized with bronchiolitis.</p><p><strong>Design: </strong>A single-center, prospective, observational study.</p><p><strong>Setting: </strong>Pediatric department of a tertiary university-affiliated hospital in Tunisia.</p><p><strong>Patients: </strong>Eighty infants under one year of age, admitted with bronchiolitis between December 2023 and February 2024, were included. Infants with comorbidities such as congenital heart disease or immunosuppression were excluded.</p><p><strong>Interventions: </strong>NT-proBNP levels were measured within 2 h of admission. Patients were managed following standard protocols, and the need for ventilatory support was documented.</p><p><strong>Main outcome measures: </strong>The association of elevated NT-proBNP levels (>1585 pg/mL) with the requirement for ventilatory support, as well as the predictive accuracy of NT-proBNP compared to the Wang score.</p><p><strong>Results: </strong>Of the 80 infants, 33.8 % had elevated NT-proBNP levels, and 18.8 % required ventilatory support. Median NT-proBNP levels were significantly higher in the ventilatory support group (2185 pg/mL) compared to those managed with room air or simple oxygen therapy (634 pg/mL). NT-proBNP demonstrated superior predictive accuracy (AUC 0.869) compared to the Wang score (AUC 0.701). A threshold of 1585 pg/mL yielded 73.3 % sensitivity and 87.7 % specificity. NT-proBNP elevation was independently associated with the need for ventilatory support (OR 17.1; 95 % CI 4.46-65.6).</p><p><strong>Conclusions: </strong>NT-proBNP levels provide valuable prognostic insights into bronchiolitis severity and outperform clinical severity scores like the Wang score in predicting ventilatory support needs. Integration of NT-proBNP measurement into clinical practice may enhance risk stratification and improve management of high-risk infants.</p>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":" ","pages":""},"PeriodicalIF":1.3000,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives De Pediatrie","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.arcped.2025.06.006","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PEDIATRICS","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: To evaluate the role of serum NT-proBNP (N-Terminal Pro Brain Natriuretic Peptide) levels as an early predictor of ventilatory support in infants hospitalized with bronchiolitis.
Design: A single-center, prospective, observational study.
Setting: Pediatric department of a tertiary university-affiliated hospital in Tunisia.
Patients: Eighty infants under one year of age, admitted with bronchiolitis between December 2023 and February 2024, were included. Infants with comorbidities such as congenital heart disease or immunosuppression were excluded.
Interventions: NT-proBNP levels were measured within 2 h of admission. Patients were managed following standard protocols, and the need for ventilatory support was documented.
Main outcome measures: The association of elevated NT-proBNP levels (>1585 pg/mL) with the requirement for ventilatory support, as well as the predictive accuracy of NT-proBNP compared to the Wang score.
Results: Of the 80 infants, 33.8 % had elevated NT-proBNP levels, and 18.8 % required ventilatory support. Median NT-proBNP levels were significantly higher in the ventilatory support group (2185 pg/mL) compared to those managed with room air or simple oxygen therapy (634 pg/mL). NT-proBNP demonstrated superior predictive accuracy (AUC 0.869) compared to the Wang score (AUC 0.701). A threshold of 1585 pg/mL yielded 73.3 % sensitivity and 87.7 % specificity. NT-proBNP elevation was independently associated with the need for ventilatory support (OR 17.1; 95 % CI 4.46-65.6).
Conclusions: NT-proBNP levels provide valuable prognostic insights into bronchiolitis severity and outperform clinical severity scores like the Wang score in predicting ventilatory support needs. Integration of NT-proBNP measurement into clinical practice may enhance risk stratification and improve management of high-risk infants.
期刊介绍：
Archives de Pédiatrie publishes in English original Research papers, Review articles, Short communications, Practice guidelines, Editorials and Letters in all fields relevant to pediatrics.
Eight issues of Archives de Pédiatrie are released annually, as well as supplementary and special editions to complete these regular issues.
All manuscripts submitted to the journal are subjected to peer review by international experts, and must:
Be written in excellent English, clear and easy to understand, precise and concise;
Bring new, interesting, valid information - and improve clinical care or guide future research;
Be solely the work of the author(s) stated;
Not have been previously published elsewhere and not be under consideration by another journal;
Be in accordance with the journal''s Guide for Authors'' instructions: manuscripts that fail to comply with these rules may be returned to the authors without being reviewed.
Under no circumstances does the journal guarantee publication before the editorial board makes its final decision.
Archives de Pédiatrie is the official publication of the French Society of Pediatrics.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
