Serum Neuronal Biomarkers in Neonates With Congenital Heart Disease Undergoing Cardiac Surgery

Trakas, Erin; Domnina, Yuliya A.; Panigrahy, Ashok; Baust, Tracy; Callahan, Patrick M.; Morell, Victor O.; Muñoz, Ricardo; Bell, Michael J.; Sanchez‐de‐Toledo, Joan

doi:10.1016/j.pediatrneurol.2017.04.011

Cited by 23 publications

(16 citation statements)

References 28 publications

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“…In the blood of 18 CHD infants undergoing open-heart surgery and cardiopulmonary bypass (CPB), higher NSE was observed in the perioperative period in infants with adverse neurological outcome [120].…”

Section: Bloodmentioning

confidence: 99%

Early predictors of perinatal brain damage: the role of neurobiomarkers

Bersani

Pluchinotta

Dotta

et al. 2019

Clinical Chemistry and Laboratory Medicine (CCLM)

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The early detection of perinatal brain damage in preterm and term newborns (i.e. intraventricular hemorrhage, periventricular leukomalacia and perinatal asphyxia) still constitute an unsolved issue. To date, despite technological improvement in standard perinatal monitoring procedures, decreasing the incidence of perinatal mortality, the perinatal morbidity pattern has a flat trend. Against this background, the measurement of brain constituents could be particularly useful in the early detection of cases at risk for short-/long-term brain injury. On this scenario, the main European and US international health-care institutions promoted perinatal clinical and experimental neuroprotection research projects aimed at validating and including a panel of biomarkers in the clinical guidelines. Although this is a promising attempt, there are several limitations that do not allow biomarkers to be included in standard monitoring procedures. The main limitations are: (i) the heterogeneity of neurological complications in the perinatal period, (ii) the small cohort sizes, (iii) the lack of multicenter investigations, (iv) the different techniques for neurobiomarkers assessment, (iv) the lack of consensus for the validation of assays in biological fluids such as urine and saliva, and (v), the lack of reference curves according to measurement technique and biological fluid. In the present review we offer an up-to-date overview of the most promising developments in the use of biomarkers in the perinatal period such as calcium binding proteins (S100B protein), vasoactive agents (adrenomedullin), brain biomarkers (activin A, neuron specific enolase, glial fibrillary acidic protein, ubiquitin carboxyl-terminal hydrolase-L1) and oxidative stress markers.

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Section: Bloodmentioning

confidence: 99%

Early predictors of perinatal brain damage: the role of neurobiomarkers

Bersani

Pluchinotta

Dotta

et al. 2019

Clinical Chemistry and Laboratory Medicine (CCLM)

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“…In our cohort there was a correlation between the duration of CPB and S100B levels immediately after surgery in infants, but surprisingly not in the group of neonates. S100B levels in previous studies were also correlated with circulatory arrest times and to the duration of CPB, which suggests a direct impact of extracorporeal circulation on astrocyte function . CPB probably initiates a marked, but transient release of S100B into the systemic circulation, which is not necessarily associated with neuronal injury.…”

Section: Discussionmentioning

confidence: 71%

“…S100B levels in previous studies were also correlated with circulatory arrest times and to the duration of CPB, which suggests a direct impact of extracorporeal circulation on astrocyte function. 27,36 CPB probably initiates a marked, but transient release of S100B into the systemic circulation, which is not necessarily associated with neuronal injury.…”

Section: Postoperative S100bmentioning

confidence: 99%

S100B and its relation to cerebral oxygenation in neonates and infants undergoing surgery for congenital heart disease

Hansen

Kissner

Logoteta

et al. 2019

Congenital Heart Disease

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Objectives: Neonates and infants undergoing surgery for congenital heart disease are at risk for developmental impairment. Hypoxic-ischemic brain injury might be one contributing factor. We aimed to investigate the perioperative release of the astrocyte protein S100B and its relation to cerebral oxygenation.Methods: Serum S100B was measured before and 0, 12, 24, and 48 hours after surgery. Cerebral oxygen saturation was derived by near-infrared spectroscopy. S100B reference values based on preoperative samples; concentrations above the 75th percentile were defined as elevated. Patients with elevated S100B at 24 or 48 hours were compared to cases with S100B in the normal range. Neonates (≤28 days) and infants (>28 and ≤365 days) were analyzed separately due to age-dependent release of S100B.Results: Seventy-four patients underwent 94 surgical procedures (neonates, n = 38;infants, n = 56). S100B concentrations were higher in neonates before and after surgery at all time points (P ≤ .015). Highest values were noticed immediately after surgery. Postoperative S100B was elevated after 15 (40.5%) surgeries in neonates.There was no difference in pre-, intra-, or postoperative cerebral oxygenation. In infants, postoperative S100B was elevated after 23 (41.8%) procedures. Preoperative cerebral oxygen saturations tended to be lower (53 ± 12% vs 59 ± 12%, P = .069) and arterial-cerebral oxygen saturation difference was higher (35 ± 11% vs 28 ± 11%, P = .018) in infants with elevated postoperative S100B. In the early postoperative course, cerebral oxygen saturation was lower (54 ± 13% vs 63 ± 12%, P = .011) and arterial-cerebral oxygen saturation difference was wider (38 ± 11% vs 30 ± 10%, P = .008). Cerebral oxygen saturation was also lower for the entire postoperative course (62 ± 18% vs 67 ± 9%, P = .047). Conclusions:Postoperative S100B was elevated in about 40% of neonates and infants undergoing cardiac surgery. Infants with elevated postoperative S100B had impaired perioperative cerebral tissue oxygenation. No relation between S100B and cerebral oxygenation could be demonstrated in neonates. K E Y W O R D Sbrain biomarkers, cardiopulmonary bypass, cerebral protection, near-infrared spectroscopy

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“…Measurement is possible in biologic fluids via commercially available assays. It has been shown to increase in patients undergoing CPB (69) and not correlated with extra-source adipose tissue release (70). However, there is a lack of studies describing normal s100β levels in the broader pediatric population.…”

Section: Biomarkers Of Cerebral Injurymentioning

confidence: 99%

“…During cardiac surgery involving hypothermic circulatory arrest, normothermic CPB or off pump cardiac surgery, CSF and serum levels of NSE have been reported to increase (69). An association between neurocognitive deficiency and NSE levels following cardiac surgery has also been reported (72).…”

Section: Biomarkers Of Cerebral Injurymentioning

confidence: 99%

Recent innovations in perfusion and cardiopulmonary bypass for neonatal and infant cardiac surgery

Sturmer¹,

Beaty²,

Clingan³

et al. 2018

Transl Pediatr

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Abstract:The development and refinement of cardiopulmonary bypass (CPB) has made the repair of complex congenital heart defects possible in neonates and infants. In the past, the primary goal for these procedures was patient survival. Now that substantial survival rates have been achieved for even the most complex of repairs in these patients, focus has been given to the reduction of morbidity. Although a necessity for these complex neonatal and infant heart defect repairs, CPB can also be an important source of perioperative complications. Recent innovations have been developed to mitigate these risks and is the topic of this review. Specifically, we will discuss improvements in minimizing blood transfusions, CPB circuit design, monitoring, perfusion techniques, temperature management, and myocardial protection, and then conclude with a brief discussion of how further systematic improvements can be made in these areas.

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Serum Neuronal Biomarkers in Neonates With Congenital Heart Disease Undergoing Cardiac Surgery

Cited by 23 publications

References 28 publications

Early predictors of perinatal brain damage: the role of neurobiomarkers

Early predictors of perinatal brain damage: the role of neurobiomarkers

S100B and its relation to cerebral oxygenation in neonates and infants undergoing surgery for congenital heart disease

Recent innovations in perfusion and cardiopulmonary bypass for neonatal and infant cardiac surgery

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