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Background: BNP is a hormone released from the cardiac ventricles in response to increased pressure and volume overload1 and is an important biomarker in heart failure. Following congenital heart surgery, elevated BNP levels correlate with longer duration of mechanical ventilation, low cardiac output syndrome, and increased ICU length of stay2-4 Mechanical ventilation (MV) has an exaggerated impact on cardiopulmonary interactions in children with myocardial dysfunction, and extubation readiness can be difficult to determine post-operatively following congenital heart surgery.

Hypothesis: An increase in post-extubation BNP levels can predict extubation failure and the need for reintubation within 48 hours.


Design: prospective, observational, blinded pilot Participants: Infants ≤ 30 days of age with RACHS- 15 score ≥3 admitted to the PICU following congenital heart surgery

Measurements: BNP levels were obtained on full MV just prior to weaning per standardized weaning protocol, one hour following a pressure support trial (PST), and at 2, 6, and 12 hours following extubation


1. Patients who failed extubation had a trend towards higher BNP levels compared to those who did not fail extubation

2. BNP levels increased in all patients with MV weaning and following extubation

3. Single ventricle patients had higher BNP


Cardiology | Critical Care | Pediatrics


Presented at the Pediatric Cardiac Intensive Care Society 9th International Conference, Miami, Fl. December 2012.

B-type Natriuretic Peptide (BNP):  A Potential Biomarker for Extubation Failure in Infants Following Cardiac Surgery



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