Elevated Plasma B-type Natriuretic Peptide and C-reactive Protein Levels in Children with Restrictive Right Ventricular Physiology Following Tetralogy of Fallot Repair
Bibliographic record
Abstract
OBJECTIVES: This study aimed to compare the levels of plasma B-type natriuretic peptide (BNP) and C-reactive protein (CRP) in relation to oxygen transport between patients with restrictive right ventricle (rRV) and those without (non-rRV) early after tetralogy of Fallot (TOF) repair. METHODS: Eighty patients (30 in the rRV group) underwent TOF repair in 2011 and 2012. BNP and CRP were repeatedly measured during postoperative day (POD) 7, along with oxygen transport variables including arterial and superior vena cava oxygen saturation (SaO2 and SvO2 ), oxygen extraction ratio (ERO2 ), and lactate. Demographic data included age and durations of cardiopulmonary bypass (CPB), aortic cross-clamping (ACC), mechanical ventilation, and ICU and hospital stays. RESULTS: During POD 7, BNP did not change in either of the two groups but was consistently higher in the rRV group (P < .0001). CRP increased from POD 1 to POD 2 and decreased thereafter. The decrease was slower in the rRV group (P = .04). The increase in SvO2 and the decrease in ERO2 were slower in the rRV group (P < .05). Lactate decreased in both groups (P < .05) but was consistently higher in the rRV group (P = .03). BNP was negatively correlated with SvO2 and preoperative SaO2 and positively correlated with ERO2 and lactate (P < .05). No correlation was found between CRP and oxygen transport variables. The rRV group was older and required longer CPB, ACC, mechanical ventilation, and ICU and hospital stays compared with the non-rRV group (P < .05 for all). CONCLUSIONS: rRV physiology is associated with significantly higher BNP and CRP levels with poorer balance of systemic oxygen transport. Information about these pathophysiological changes may help to identify appropriate treatment strategies in this difficult group of patients.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".