Biomarkers May ID Newborns at Risk for Death and Brain Injury after Heart Surgery

In newborns undergoing cardiac surgery, diagnosing early brain injury is important for timely intervention. However, it is difficult to evaluate sedated, mechanically ventilated infants. according to Barbara Weissman, MD, associate professor of pediatrics at Emory University School of Medicine and a pediatric neurologist at Emory-Children’s Center, and colleagues set out to determine whether using a blood test would be a more efficient and accurate method of evaluating newborns undergoing cardiac surgery.

This single-center study evaluated the sensitivity, specificity, and clinical utility of using a blood test to evaluate newborns. The study included 10 neonates undergoing cardiac surgery using cardiopulmonary bypass, with researchers performing preoperative and postoperative brain MRIs, maternal and patient blood samples for biomarkers S-100B (a calcium-binding protein) and NSE (neuron-specific enolase, commonly used as a tumor marker). Neurodevelopmental testing was conducted between the ages of 6 and 10 months.

According to the results, both S-100B and NSE were useful in identifying newborns at risk for death and abnormal neurodevelopmental outcomes after surgery. Preoperative S-100B also predicted abnormal preoperative brain MRI.
Dr. Weissman said “It is interesting that S-100B and NSE seem to be helpful predictors of brain injury risk. The results of this study certainly justify further research and long-term follow-up of this at-risk population."

Clinical Topics: Cardiac Surgery, Congenital Heart Disease and Pediatric Cardiology, Invasive Cardiovascular Angiography and Intervention, Cardiac Surgery and CHD & Pediatrics, CHD & Pediatrics and Interventions, CHD & Pediatrics and Quality Improvement

Keywords: Infant, Newborn, Follow-Up Studies, Biological Markers, Brain Injuries, Sensitivity and Specificity, Cardiopulmonary Bypass, Cardiac Surgical Procedures

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