Association of intraoperative circulating-brain injury biomarker and neurodevelopmental outcomes at 1 year among neonates who have undergone cardiac surgery

The Journal of Thoracic and Cardiovascular Surgery
Eric M GrahamAllen D Everett

Abstract

Neurodevelopmental disability is the most significant complication for survivors of infant surgery for congenital heart disease. In this study we sought to determine if perioperative circulating brain injury biomarker levels are associated with neurodevelopmental outcomes at 12 months. A secondary analysis of a randomized controlled trial of neonates who underwent cardiac surgery was performed. Glial fibrillary acidic protein (GFAP) was measured: (1) before skin incision; (2) immediately after bypass; (3) 4 and (4) 24 hours postoperatively. Linear regression models were used to determine an association with the highest levels of GFAP and Bayley Scales of Infant and Toddler Development third edition (BSID) composite scores. There were 97 subjects who had cardiac surgery at a mean age of 9 ± 6 days and completed a BSID at 12.5 ± 0.6 months of age. Median (25th-75th percentile) levels of GFAP were 0.01 (0.01-0.02), 0.85 (0.40-1.55), 0.07 (0.05-0.11), and 0.03 (0.02-0.04) ng/mL at the 4 time points, respectively. In univariate analysis GFAP was negatively associated with cognitive, language, and motor composite scores. GFAP levels immediately after bypass differed between institutions; 1.57 (0.92-2.48) versus 0.77 (0.36-1.21) ng/mL...Continue Reading

References

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Citations

Sep 5, 2019·Current Opinion in Pediatrics·Brian R WhiteMatthew P Kirschen
Nov 7, 2019·Current Opinion in Pediatrics·Brian R WhiteMatthew P Kirschen
Jul 11, 2019·The Journal of Thoracic and Cardiovascular Surgery·David M Overman
Apr 18, 2021·The Annals of Thoracic Surgery·Sinai C ZyblewskiEric M Graham
Apr 30, 2019·The Journal of Thoracic and Cardiovascular Surgery·Charles B Huddleston, Andrew C Fiore

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