Age Reference Range (pg/mL) Pediatric (boys and girls) 0-30 days 263 - 6500 1 month - 11 months 37 - 1000 12 months - 35 months 39 - 675 3 years to 6 years 23 - 327 7 years to 14 years 10 - 242 15 years to 18 years 6 - 207 Males 19-44 years 0 - 93 45-54 years 0 - 138 55-64 years 0 - 177 65-74 years 0 - 229 75 years or older 0 - 852 Females 19-44 years 0 - 178 45-54 years 0 - 192 55-64 years 0 - 226 65-74 years 0 - 353 75 years or older 0 - 624 Reference ranges in adults reflect 95th percentiles for NT-pro-BNP levels in patients without congestive heart failure (CHF). Knowledge of each individual patient's NT-proBNP range may be more useful than using similar cut-points for every patient. For adult chronic CHF patients according to New York Heart Association (NYHA) Functional Class for NT-proBNP levels in pg/mL: Mean 5th percentile 95th percentile Class I: 1015 33 3410 Class II: 1666 103 6567 Class III: 3029 126 10449 Class IV: 3465 148 12188 Pediatric reference ranges for patients 18 years and younger are from reference (1). Among patients with dyspnea, NT-proBNP is highly sensitive for the detection of acute CHF. In addition, a NT-proBNP < 300 pg/mL effectively rules out acute CHF, with 99% negative predictive value. Elevations in NT-proBNP levels may be observed in states other than left ventricular congestive failure including: acute coronary syndromes, right heart strain/failure (including pulmonary embolism and cor pulmonale), critical illness, and renal failure. Falsely low NT- proBNP in CHF patients may be observed in increased body mass index. References: (1) Nir A et al. Pediatr Cardiol 30:3-8, 2009.

The N-terminal Pro-Brain Natriuretic Peptide (Pro-BNP) is an assay used as an aid in the diagnosis of individuals suspected of having congestive heart failure. The test is further indicated for the risk stratification of patients with acute coronary syndrome and congestive heart failure. The test may also be used as an aid in the assessment of increased risk of cardiovascular events and mortality in patients at risk for heart failure who have stable coronary artery disease. NT-Pro-BNP is stable for three days at 2-8°C, so this assay may be added to existing PST tubes during those two days.

Hemolysis H = 1000 Lipemia L = 1500 Icterus I = 25 Biotin <82 nmol/L or <30 ng/mL In patients receiving therapy with high biotin >5mg/day, no sample should be taken until at least 8 hours after last biotin administration.