NT-PROBNP as a screening tool for low-risk patent ductus arteriousus: a follow-up validation study

The purpose of the study is to test whether NT-proBNP serves as a screening tool for low-risk patent ductus arteriosus and safely avoids routine early echocardiography. This is a prospective observational study in preterm infants ≤ 32 weeks of gestational age. Infants with ≥5100 pg/ml (positive screening) at 48–72 hours of life received comprehensive echocardiography and were treated according to shunt severity. Infants with NT-proBNP below 5100 pg/ml (negative screening) were managed expectantly. The main outcome was need for ductus treatment within the first 7 days of life. One hundred twenty-five infants were included; 82 had a negative NT-proBNP screening and 43 had a positive NT-proBNP screening. No infant (0%) with a negative screening was treated for ductus while 26 (60.4%) with a positive screening were treated ( p < 0.001). NT-proBNP avoided a 65.6% of routine echocardiograms. NT-proBNP had an excellent performance to predict PDA treatment (AUC = 0.967). Conclusion : NT-proBNP at 48–72 hours of life has an excellent performance to detect low risk and avoids unnecessary echocardiograms. This may contribute to optimize PDA management in terms of resource utilization. What is Known: • Patent ductus arteriosus is associated with significant morbidity in preterm infants. • Early echocardiography screening and individualized treatment of high-risk preterm infants may improve outcomes but is resource consuming. What is New: • NT-proBNP can be used as a screening tool to detect low-risk patent ductus arteriosus. • Using NT-proBNP as a screening tool safely avoids a significant proportion of routine echocardiography and may improve resource utilization.