Background: Cardiac arrest in children is associated with high morbidity and mortality, primarily due to neurological injury. Biomarkers linked to brain injury, released into circulation from compromised elements of the neurovascular unit, act as significant prognostic indicators in patients suffering from hypoxic-ischemic brain injury (HIBI) subsequent to the restoration of spontaneous circulation (ROSC) after pediatric cardiac arrest. The aim of this systematic review and meta-analysis is to evaluate the prognostic utility of brain injury biomarkers in predicting neurological outcomes and survival in patients following cardiac arrest in the pediatric population.
Methods: Bibliographic databases (PubMed, the Cochrane Library, and Embase) were searched from their inception to November 2024. A random-effect model was used for all analyses.
Results: Our meta-analysis demonstrates significant associations between various biomarkers and survival or neurological outcomes after cardiac arrest. Neuron-specific enolase (NSE) levels were consistently elevated in non-survivors and patients with unfavorable neurological outcomes, with pronounced differences observed on Days 2 and 3 (e.g., Day 3 mean difference: -88.48, 95%CI: -146.77 to -30.19, P = 0.003). Emerging biomarkers, including UCH-L1 and GFAP, showed striking differences, such as elevated UCH-L1 levels on Day 1 (mean difference: -415.41, 95%CI: -474.41 to -356.61, P < 0.001) and GFAP levels exceeding 4000 ng/mL in non-survivors on Day 2 (P < 0.001).
Conclusions: Our findings underscore the significant prognostic value of biomarkers in predicting survival and neurological outcomes following cardiac arrest. Neuron-specific enolase (NSE) consistently demonstrated its reliability across multiple time points, while emerging biomarkers like UCH-L1 and GFAP showed promising potential for early outcome stratification.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.5603/cj.103883 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Background: The perioperative management of patients undergoing cardiac surgery is highly complex and involves numerous factors. There is a strong association between cardiac surgery and perioperative complications. The Brazilian Surgical Identification Study (BraSIS 2) aims to assess the incidence of death and early postoperative complications, identify potential risk factors, and examine both the demographic characteristics of patients and the epidemiology of cardiovascular procedures.
View Article and Find Full Text PDFTrends in Cardiac Arrest Outcomes & Management in Children with Cardiac Illness Category Compared to Non-Cardiac Illness Category: An Analysis from the AHA Get With The Guidelines®-Resuscitation Registry.
Resuscitation
December 2024
Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States.
Introduction: Contemporary rates of survival after pediatric in-hospital CPR events and trends in survival over the last 20 years have not been compared based on illness category. We hypothesized that survival to hospital discharge for surgical-cardiac category is higher than the non-cardiac category, and rates of survival after in-hospital CPR increased over time in all categories.
Methods: The AHA Get With The Guidelines®-Resuscitation registry was queried for index CPR events in children < 18 years of age from 2000 to 2021.
A case of fatal acute saddle embolism of the terminal aorta after long-term support using Impella CP.
J Artif Organs
March 2025
Department of Cardiovascular Surgery, The Sakakibara Heart Institute of Okayama, 2-5-1 Nakaicho, Kita-ku, Okayama, 700-0804, Japan.
A 69-year-old male diagnosed with subacute myocardial infarction was subsequently transferred to our institution. Upon admission, echocardiography revealed ventricular septal rupture (VSR). The patient was promptly supported via venoarterial (VA) extracorporeal membrane oxygenation (ECMO) and Impella CP before surgical VSR repair on the 12th day of admission.
View Article and Find Full Text PDFTrends in Cardiac Arrest Among Heart Failure Patients Aged 25 and Older in the United States: Insights from the CDC WONDER Database: Cardiac Arrest Mortality Trends in Heart Failure.
Am J Cardiol
March 2025
Department of Cardiology, Lahey Hospital and Medical Center, Burlington, MA.
The National Association of Emergency Medical Services Physicians (NAEMSP), American College of Surgeons Committee on Trauma (ACS-COT), and American College of Emergency Physicians (ACEP) believe that evidence-based, pragmatic, and collaborative protocols addressing the care of patients with traumatic out-of-hospital circulatory arrest (TOHCA) are needed to optimize patient outcomes and clinician safety. When the etiology of arrest is unclear, particularly without clear signs of life-threatening trauma, standard basic and advanced cardiac life support (BCLS/ACLS) treatments for medical cardiac arrest is appropriate. Traumatic circulatory arrest may result from massive hemorrhage, airway obstruction, obstructive shock, respiratory disturbances, cardiogenic causes or massive head trauma.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!