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Serum concentration of copeptin in newborns with congenital heart defect
1
Oddział Neonatologii, Patologii i Intensywnej Terapii Noworodka, Górnośląskie Centrum Zdrowia Dziecka im. św. Jana Pawła II, Samodzielny Publiczny Szpital Kliniczny nr 6 Śląskiego Uniwersytetu Medycznego w Katowicach
2
Klinika Neonatologii, Patologii i Intensywnej Terapii Noworodka, Wydział Nauk Medycznych w Katowicach, Śląski Uniwersytet Medyczny w Katowicach
Corresponding author
Iwona Maruniak-Chudek
Klinika Neonatologii, Patologii i Intensywnej Terapii Noworodka, Wydział Nauk Medycznych w Katowicach, Śląski Uniwersytet Medyczny w Katowicach, ul. Medyków 16, 40-752 Katowice
Klinika Neonatologii, Patologii i Intensywnej Terapii Noworodka, Wydział Nauk Medycznych w Katowicach, Śląski Uniwersytet Medyczny w Katowicach, ul. Medyków 16, 40-752 Katowice
Ann. Acad. Med. Siles. 2021;75:41-48
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Neonates with congenital heart defects (CHD) require careful fluid management due to the risk of cardiovascular failure. Routine laboratory parameters are not the optimal tool to detect fluid overload; therefore the search for novel markers is justified. Copeptin (pre-pro-vasopressin – CTproAVP) may be one of them. The aim of the study was to analyze the influence of the current protocol of hydration in neonates with CHD on the physiological volume homeostasis measured with CTproAVP.
Material and methods:
Ten term newborns with CHD hospitalized in neonatal intensive care before cardiac surgery were enrolled in the study. Four of them presented symptoms of respiratory insufficiency and all except two received alprostadil. Clinical management was routine, with the exception of CTproAVP measurement in the first five days of life with evaluation of serum and urine osmolality. Fluid intake was within the normal range for age. Term, healthy neonates (N = 200) served as the control.
Results:
The current hydration protocol did not cause an increase in serum and urine osmolality compared to the controls. The effective osmolality of the analyzed body fluids was even lower in the neonates with CHD. The concentration of CTproAVP was also lower in the study group, but the difference was not statistically significant. There were no clinical signs of cardiovascular distress or overhydration. No factors explaining the variability in CTproAVP concentration were identified.
Conclusions:
These preliminary data suggest that the protocol of hydration does not cause dehydration or stimulation of CTproAVP release. It seems that even more restrictive protocols of fluid management can be applied in newborns with CHD at the risk of pulmonary congestion. A longer observation period is needed, including the postoperative period, to obtain more reliable information on optimal fluid management and the role of CTproAVP in monitoring volemia.
Neonates with congenital heart defects (CHD) require careful fluid management due to the risk of cardiovascular failure. Routine laboratory parameters are not the optimal tool to detect fluid overload; therefore the search for novel markers is justified. Copeptin (pre-pro-vasopressin – CTproAVP) may be one of them. The aim of the study was to analyze the influence of the current protocol of hydration in neonates with CHD on the physiological volume homeostasis measured with CTproAVP.
Material and methods:
Ten term newborns with CHD hospitalized in neonatal intensive care before cardiac surgery were enrolled in the study. Four of them presented symptoms of respiratory insufficiency and all except two received alprostadil. Clinical management was routine, with the exception of CTproAVP measurement in the first five days of life with evaluation of serum and urine osmolality. Fluid intake was within the normal range for age. Term, healthy neonates (N = 200) served as the control.
Results:
The current hydration protocol did not cause an increase in serum and urine osmolality compared to the controls. The effective osmolality of the analyzed body fluids was even lower in the neonates with CHD. The concentration of CTproAVP was also lower in the study group, but the difference was not statistically significant. There were no clinical signs of cardiovascular distress or overhydration. No factors explaining the variability in CTproAVP concentration were identified.
Conclusions:
These preliminary data suggest that the protocol of hydration does not cause dehydration or stimulation of CTproAVP release. It seems that even more restrictive protocols of fluid management can be applied in newborns with CHD at the risk of pulmonary congestion. A longer observation period is needed, including the postoperative period, to obtain more reliable information on optimal fluid management and the role of CTproAVP in monitoring volemia.
FUNDING
This study was supported by a grant from Medical University of Silesia (KNW – 2-K20/N/6/N)
CONFLICT OF INTEREST
The authors declare that there is no conflict of interests regarding the publication of this paper.
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