Objective: To investigate whether S100B could be used as a marker for brain injury in children with congenital heart defects (CHD) undergoing cardiac surgery
Background: Brain injury is a major source of morbidity in children with CHD undergoing cardiac surgery. Early identification of brain injury can assist in improving neurological outcome by supportive care and future neuro-protective interventions. Serum S100B has been suggested as an early marker for brain injury. High S100B levels have been correlated with hypoxic-ischemic encephalopathy in neonates, poor neurological outcome after cardiac arrest in children and death after pediatric cardiac surgery.
Methods: 75 patients were enrolled in the study. S100B was measured before surgery, 6, 12 and 24 hours after surgery. S100B levels were standardized by age. Neurological function was clinically evaluated before surgery and at discharge, using the Pediatric Stroke Outcome Measure (PSOM) scale. New neurological injury was defined as a one point increase of the PSOM score at discharge in comparison to baseline.
Results: 20 subjects developed new neurological deficit after surgery. 55 subjects had no change in neurological function. Injured subjects had significantly higher standardized S100B levels in comparison to non-injured subjects at all time points. A cut-off of 3 standard deviations 6h after surgery had a positive predictive value of 79% and a negative predictive value of 90% for detection of new neurological deficits.
Conclusion: The current study suggests that S100B can be used as an early marker for brain injury in children undergoing cardiac surgery.
