Neuroethics · 2018
Ethics of Deep Brain Stimulation in Adolescent Patients with Refractory Tourette Syndrome: a Systematic Review and Two Case Discussions.
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Smeets Anouk Y J M, Duits A A, Horstkötter D, Verdellen C, de Wert G, Temel Y, Ackermans L, Leentjens A F G
Аннотация
OBJECTIVE: To explore changes of plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) level in children having undergone radical operation of tetralogy of Fallot (TOF) and its clinical significance.
PATIENTS AND METHODS: 52 cases of children with TOF hospitalized in our hospital from October 2011 to April 2013 were chosen, and they were all treated with radical operation of TOF. Levels of plasma NT-proBNP in these children were measured before the operation, and 3h, 12h, 48h, 1 week, 1 months, and 3 months after the operation. The cardiac color supersonic diagnostic set was used to examine pulmonary artery transvalvular pressure gradient, right ventricular end-diastolic volume (RVEDV), left ventricular ejection fraction (LVEF), and right ventricular Tei index.
RESULTS: (1) 3h after the operation, the level of NT-proBNP gradually rose and reached its peak 48h after the operation, which was markedly higher than the level before the operation (p < 0.01), yet the levels measured 1 month and 3 months after the operation were lower than the level before the operation (p < 0.05). (2) 1 week after the operation, NT-proBNP level, pulmonary artery transvalvular pressure gradient, and RVEDV of the group with right ventricular dysfunction were markedly higher than those of the group with normal right ventricular function (p < 0.05). (3) 3 months after the operation, levels of plasma NT-proBNP of children in the severe reflux group and moderate reflux group were markedly higher than those in the slight reflux group (p < 0.05); levels of plasma NT-proBNP of children in the severe reflux group were markedly higher than those of the slight reflux group (p < 0.05) 1 week or 3 months after the operation.
CONCLUSIONS: Changes of the NT-proBNP level during early stage after radical operation of children's TOF were in line with changes of the right ventricular function and could be regarded as an objective indicator for evaluating the right ventricular function.
PATIENTS AND METHODS: 52 cases of children with TOF hospitalized in our hospital from October 2011 to April 2013 were chosen, and they were all treated with radical operation of TOF. Levels of plasma NT-proBNP in these children were measured before the operation, and 3h, 12h, 48h, 1 week, 1 months, and 3 months after the operation. The cardiac color supersonic diagnostic set was used to examine pulmonary artery transvalvular pressure gradient, right ventricular end-diastolic volume (RVEDV), left ventricular ejection fraction (LVEF), and right ventricular Tei index.
RESULTS: (1) 3h after the operation, the level of NT-proBNP gradually rose and reached its peak 48h after the operation, which was markedly higher than the level before the operation (p < 0.01), yet the levels measured 1 month and 3 months after the operation were lower than the level before the operation (p < 0.05). (2) 1 week after the operation, NT-proBNP level, pulmonary artery transvalvular pressure gradient, and RVEDV of the group with right ventricular dysfunction were markedly higher than those of the group with normal right ventricular function (p < 0.05). (3) 3 months after the operation, levels of plasma NT-proBNP of children in the severe reflux group and moderate reflux group were markedly higher than those in the slight reflux group (p < 0.05); levels of plasma NT-proBNP of children in the severe reflux group were markedly higher than those of the slight reflux group (p < 0.05) 1 week or 3 months after the operation.
CONCLUSIONS: Changes of the NT-proBNP level during early stage after radical operation of children's TOF were in line with changes of the right ventricular function and could be regarded as an objective indicator for evaluating the right ventricular function.