B-Type Natriuretic Peptide (BNP) in Neonates, Infants and Children Undergoing Cardiac Surgery

In 1988 Sudoh and colleagues described a novel natriuretic peptide in porcine brain -brain natriuretic peptide(Sudoh et al. 1988). In fact, the peptide is most abundant in the heart and thus it is now commonly termed B-type natriuretic peptide (BNP). Myocyte pressure and/or stretch results in the release of BNP, and BNP levels are easily quantified by several commercially available assays. Data from numerous studies have now firmly established a role for BNP as a biomarker for diagnosis, prognostication, and management of adults with cardiac disease, including those undergoing cardiac surgery(Silver et al. 2004; Mitchell and Webb 2011; Rodseth, Padayachee, and Biccard 2008; Fellahi et al. 2011). Unfortunately, far fewer data are available on the role of BNP in the management of neonates, infants, and children who require cardiac surgery. This chapter will provide a brief review of these data in order to understand the potential utility of BNP determinations in this population.