Serum neuronal biomarkers in neonates with congenital heart disease undergoing cardiac surgery

Publication date: Available online 21 April 2017
Source:Pediatric Neurology
Author(s): Erin Trakas, Yuliya Domnina, Ashok Panigrahy, Tracy Baust, Patrick M. Callahan, Victor O. Morell, Ricardo Munoz, Michael J. Bell, Joan Sanchez-de-Toledo
BackgroundNewborns with Congenital Heart Disease have associated brain damage that impacts short and long term neurodevelopment. Several neuronal biomarkers exist that could predict brain damage. We aim to investigate the pattern of neuron specific enolase (NSE) and s100B levels following cardiopulmonary bypass surgery in neonates with congenital heart disease.Materials and MethodsProspective observational study including neonates with congenital heart disease undergoing cardiopulmonary bypass surgery. NSE and s100B were measured from serum samples obtained preoperatively, immediately postoperatively, and once daily on postoperative days 1-7. Cranial ultrasounds were obtained preoperatively and postoperatively and findings were scored utilizing an internally developed scoring system.ResultsEighteen neonates were included. Immediate postoperative and peak levels of both NSE [58.0 (21.6) and 68.1 (55.7) μg/L] and s100B [0.14 (0.3] and 0.14 (0.3) μg/L] were significantly elevated when compared with preoperative levels [34.0 (21.6) μg/L; p<0.01 and 0.08 (0.1) μg/L; p<0.02]. By postoperative day 7, NSE and s100B levels were lower than preoperative levels: NSE [18 (5.7) p 0.09) and s100B [0.03 (0.05); p < 0.01)]Postoperative s100B levels were negatively correlated to age at surgery and positively correlated with circulatory arrest time. While there was no significant correlation between either NSE or s100B levels and ICU length of stay, hospital length of stay and PCPC score, there was a negative correlation between postoperative levels of NSE and ventriculomegaly.ConclusionsNSE and s100B levels increase following bypass surgery and return below preoperative baseline levels by postoperative day 7. S100B levels were positively correlated with circulatory arrest time and negatively correlated with age at time of surgery. This may be supportive of preexisting prenatal brain injury that could be enhanced by longer surgical times but also of some brain protection effect associated with longer wait until surgery.



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