Serum BNP do not increase in pediatric trauma patients with serious head injuries: Report

Investigators at Childrens Hospital Los Angeles have found that unlike adults, levels of serum beta-natriuretic peptide (BNP) do not increase in pediatric trauma patients with serious head injuries.

Serum BNP is a hormone produced by the heart. Blood levels of BNP rise as the heart is required to work harder. Recent reports in the medical literature show that BNP increases in adult trauma patients, especially in those with traumatic brain injury and intracranial bleeding. This correlation has led researchers to consider using BNP as a "marker" for traumatic brain injury. Currently, physicians rely on head computed tomography, also known as CT scans, for diagnosis. Since CT scans take additional time, are expensive, and expose the patient to radiation, using a blood test to screen patients with head injury would represent a significant advancement in patient care.

"Pediatric patients are affected by even small amounts of radiation making the use of a marker especially attractive," explains Dr Alan Nager, MD, Director of the Division of Emergency Medicine and Transport Medicine at Childrens Hospital Los Angeles, an investigator at The Saban Research Institute at Childrens Hospital and associate professor of pediatrics at the Keck School of Medicine of the University of Southern California. He and his colleague Todd P. Chang, MD, also from Childrens Hospital Los Angeles, published the results of their study in the June issue of The Journal of Trauma. "We took serum samples from 95 consecutive Level I trauma patients as soon as they arrived in the emergency room. We also obtained head CT scans," says Dr Nager. "We expected that patients with elevated BNP levels would be the ones with intracranial bleeding."

The physicians did not find that correlation. Levels of BNP drawn at the time of the emergency room visit did not seem to be a reliable predictor for intracranial hemorrhage in pediatric trauma patients. "A head CT scan is still the best test for diagnosing intracranial hemorrhage," concludes Dr Nager. "This is why we study children. We can't say that because something happens in adults, the same thing will happen in kids. They're not just small adults. Children can have different clinical responses and this is one of them."