Neurological deficit is predicted by S100B in children after cardiac surgery

• Published in: Clinica chimica acta Vol. 481; pp. 56 - 60
• Main Authors: Bar-Yosef, O., Greidinger, D., Iskilova, M., Hemi, R., Tirosh, T., Vardi, A.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.06.2018
• Subjects: Brain injury; Congenital heart defects; Neurology; Pediatric intensive care unit; S100B; PCPC; PSOM; NND; ROC; H; S100B; Congenital heart defects; AUC; Neurology; CPB; Pediatric intensive care unit; GCS; CHD; Brain injury
• ISSN: 0009-8981; 1873-3492
• DOI: 10.1016/j.cca.2018.02.032

Children undergoing cardiac surgery may suffer from brain injuries after surgery and develop neurological deficit. Early diagnosis of brain injury after surgery would enable early therapeutic interventions. The aim of the study is to test whether S100B can serve as a biomarker for brain injury after cardiac surgery. Seventy-five patients were enrolled in the study. Serum S100B was collected at the beginning of the surgery, and 6, 12, 24 h after surgery. S100B z-scores were calculated based on norms for age. Neurological evolutions were done before surgery and at discharge by the Pediatric Stroke Outcome Measure (PSOM). New neurological deficit (NND) was defined as a 1 point increase on the PSOM scale. Twenty patients had an NND after cardiac surgery. Medical background was similar between the groups with and without NND. S100B z-scores were significantly higher in the NND group at all time points after surgery. Using a cut-off of 3 z-score at 6 h after surgery, the positive predictive value was 79% and the negative predictive value was 90%. S100B is a potent early biomarker for brain injury after cardiac surgery. Hopefully, S100B could be used to prevent progression of brain injuries after cardiac surgery. •Neurological deficit is a known complication in children after heart surgery.•Serum S100B after surgery was tested for diagnosis of the new neurological deficit.•S100B at 6 h after surgery were associated with new neurological deficit.•When new deficit occurred, S100B levels were constantly increased for 24 h.•S100B levels after surgery had a high predictive power for new neurological deficit.