Study on the predictive value of NT-proBNP for death within 28 days of acute respiratory fail-ure in children requiring invasive mechanical ventilation
Objective:To explore the predictive value of oxygenation index(OI)and N-terminal pro-B-type na-triuretic peptide(NT-proBNP)within 28 days of death in pediatric intensive care unit(PICU)patients with acute respiratory failure(ARF)requiring invasive mechanical ventilation.Methods:Clinical data of 111 children with ARF who were admitted to PICU in the First Affiliated Hospital of Guangxi Medical University and required in-vasive mechanical ventilation from 2017 to 2019 were collected and analyzed,including the Pediatric Risk of Mortality Ⅲ scores(PRISM Ⅲ),OI,NT-proBNP,and survival within 28 days after mechanical ventilation.Uni-variate and multivariable logistic regression analysis were used to assess the risk factors for death within 28 days in children with ARF.Receiver operating characteristic(ROC)curves were drawn to evaluate the effect of NT-proBNP,OI,and age in predicting 28-day survival.Results:The median age was 12 months(4.5-66 months),with 79 survivors(71.17%)and 32 non-survivors(28.83%)within 28 days.OI was significantly higher,while NT-proBNP was significantly lower in the non-survivor group compared with the survivor group(both P＜0.05),and there was no difference in the PRISMⅢbetween the two groups within 24 h(P＞0.05).Multivariate logistic re-gression analysis showed that age,OI and NT-proBNP were independent risk factors for death in children with ARF within 28 days(P＜0.05).The area under ROC curve(AUC)of age,OI,NT-proBNP and their combination were 0.6250,0.6036,0.6028 and 0.6572,respectively.The combination of age+OI+NT-proBNP had a better pre-diction effect.Conclusion:In children with ARF requiring mechanical ventilation,age,OI and NT-proBNP lev-els in the first 24 hours are associated with 28-day mortality risk.The combination of age,OI,and NT-proBNP is helpful for early identification of mortality risk in intubated children with ARF.
oxygenation indexN-terminal pro-B-type natriuretic peptidemorality riskpediatric intensive care unitrespiratory failure
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