Serum biomarkers of brain injury to classify outcome after pediatric cardiac arrest*.
Serum biomarkers of brain injury to classify outcome after pediatric cardiac arrest*.
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DOI：
10.1097/01.ccm.0000435668.53188.80
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发表时间：
2014-03
影响因子：
8.8
通讯作者：
Kochanek PM
中科院分区：
文献类型：
--
作者：
Fink EL;Berger RP;Clark RS;Watson RS;Angus DC;Richichi R;Panigrahy A;Callaway CW;Bell MJ;Kochanek PM
心脏骤停（CA）儿童的发病率和死亡率很大程度上是由神经损伤造成的。脑损伤的血清生物标志物可以潜在地测量神经元（神经元特异性烯醇化酶 [NSE]）、星形胶质细胞（S100b）和轴突（髓磷脂碱性蛋白 [MBP]）的损伤。我们假设血清生物标志物可用于预测儿科 CA 的结果。前瞻性观察研究。单一三级儿科医院。四十三名儿童心脏骤停。没有任何。我们在 CA 后第 1-4 天和第 7 天测量了血清 NSE、S100b 和 MBP。我们记录了出院时和 6 个月时的人口统计数据、CA 和复苏的详细信息以及儿科脑功能类别 (PCPC)。我们分析了 24、48 和 72 小时生物标志物水平与良好（PCPC 1-3）或不良（PCPC 4-6）结果和死亡率的关联。入组了 43 名儿童（49% 女性；平均年龄 5.9 ± 6.3 岁），其中 17 名 (40%) 死亡。所有 3 种生物标志物的 24 小时血清浓度均预测死亡率（全部 p<0.05）。此外，与良好结果组相比，以及在所有时间点死亡的受试者中，血清 NSE 和 S100b 浓度均升高（全部 p<0.05）。血清 S100b 的受试者工作曲线血清生物标志物浓度和受试者体温之间没有关联，血清 S100b、NSE 和 MBP 可以预测 6 个月时的良好结果和不良结果，这可能有助于预测 CA 幸存儿童的结果。
Morbidity and mortality in children with cardiac arrest (CA) largely result from neurologic injury. Serum biomarkers of brain injury can potentially measure injury to neurons (neuron specific enolase [NSE]), astrocytes (S100b), and axons (myelin basic protein [MBP]). We hypothesized that serum biomarkers can be used to predict outcome from pediatric CA. Prospective observational study. Single tertiary pediatric hospital. Forty-three children with cardiac arrest. None. We measured serum NSE, S100b, and MBP on days 1–4 and 7 after CA. We recorded demographics, details of the CA and resuscitation, and Pediatric Cerebral Performance Category (PCPC) at hospital discharge and 6 months. We analyzed the association of biomarker levels at 24, 48, and 72 hours with good (PCPC 1–3) or poor (PCPC 4–6) outcome and mortality. Forty-three children (49% female; mean age of 5.9 ± 6.3 were enrolled and 17 (40%) died. Serum concentration at 24 hours for all 3 biomarkers predicted mortality (all p<0.05). Additionally, serum NSE and S100b concentrations were increased in the poor outcome vs. good outcome group and in subjects who died at all time points (all p<0.05). Receiver operator curves for serum S100b and NSE to predict good vs. poor outcome at 6 months was superior to clinical predictors. There was no association between serum biomarker concentrations and subject temperature. Preliminary data show that serum S100b, NSE, and MBP may aid in outcome prediction of children surviving CA.
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影响因子：
4.1
作者：
Berger, Rachel;Richichi, Rudolph
通讯作者：
Richichi, Rudolph
DOI：
10.1097/pcc.0b013e3181fe27c7
发表时间：
2012-01
期刊：
Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
影响因子：
--
作者：
Fink EL;Kochanek PM;Clark RS;Bell MJ
通讯作者：
Bell MJ
DOI：
10.1097/pcc.0b013e3182196a7b
发表时间：
2012-01
期刊：
Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
影响因子：
--
作者：
Abend NS;Topjian AA;Kessler SK;Gutierrez-Colina AM;Berg RA;Nadkarni V;Dlugos DJ;Clancy RR;Ichord RN
通讯作者：
Ichord RN
影响因子：
6.2
作者：
Donoghue, AJ;Nadkarni, V;Stiell, IG
通讯作者：
Stiell, IG
影响因子：
4.8
作者：
Anderson, RE;Hansson, LO;Settergren, G
通讯作者：
Settergren, G