NPPB and hydrops fetalis: Nesiritide, approved by the FDA for the therapy of acute decompensated HF in 2001, is a successful rhBNP that has several biological functions that are similar to endogenous BNP, including facilitating natriuresis, diuresis, inhibiting RAAS, increasing output of the heart, decreasing wedge pressure in pulmonary capillaries, and improving cardiac diastolic and systolic function [80,81,82,83].