ArticlePediatric research2026
Pediatric congenital heart disease: inflammatory biomarkers mediate the association between preoperative ZlogNT-proBNP and postoperative prolonged ventilation.
Article in Pediatric research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundChildren with congenital heart disease (CHD) often exhibit elevated preoperative NT-proBNP, linked to prolonged postoperative mechanical ventilation. Age-adjusted ZlogNT-proBNP outperforms raw NT-proBNP in predicting outcomes, but its relationship with ventilation duration and underlying inflammatory pathways remain unclear.
methodsThis retrospective cohort study included 113 CHD children. Preoperative ZlogNT-proBNP were quantified and perioperative cytokines (IL-6, IL-8, IL-10) were measured, as well as postoperative ventilation duration were recorded. Multivariable regression and mediation analyses assessed direct and indirect cytokine-mediated effects on prolonged ventilation.
resultsAmong the 113 children, 28 (25%) experienced prolonged mechanical ventilation and had significantly higher preoperative ZlogNT-proBNP compared to those with shorter mechanical ventilation durations. Postoperatively, IL-6, IL-8, and IL-10 levels were significantly elevated in the prolonged mechanical ventilation group. Mediation analysis revealed that IL-6, IL-8, and IL-10 partially mediated the association between ZlogNT-proBNP and prolonged mechanical ventilation, with mediation proportions of 28%, 38%, and 37%, respectively.
conclusionElevated preoperative ZlogNT-proBNP was significantly associated with prolonged mechanical ventilation, partly via cytokine-mediated inflammatory pathways. These findings suggest that targeting inflammatory pathways may help optimize perioperative care and reduce ventilation duration. IMPACT: 1. Preoperative ZlogNT-proBNP levels and postoperative inflammatory markers (IL-6, IL-8, and IL-10) are significantly associated with prolonged postoperative mechanical ventilation duration. 2. Postoperative inflammatory cytokines (IL-6, IL-8, and IL-10) partially mediate the association between preoperative ZlogNT-proBNP levels and prolonged MV duration.
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