Association of Blood-Based Brain Injury Biomarker Concentrations With Outcomes After Pediatric Cardiac Arrest

作者：Ericka L. Fink, Patrick M. Kochanek, Ashok Panigrahy, Sue R. Beers, Rachel P. Berger, Hülya Bayır, Jose Pineda, Christopher J. L. Newth, Alexis Topjian, Craig A. Press, Aline B. Maddux, Frederick Willyerd, Elizabeth A. Hunt, Ashley Siems, Melissa G. Chung, Lincoln Smith, Jesse Wenger, Lesley Doughty, J. Wesley Diddle, Jason Patregnani, Juan Piantino, Karen Walson, Binod Balakrishnan, Michael T. Meyer, Stuart H. Friess, David G. Maloney, Pamela Rubin, Tamara Haller, Amery Treble‐Barna, Chunyan Wang, Robert Clark, Anthony Fabio, Personalizing Outcomes After Child Cardiac Arrest (POCCA) Investigators, David G. Maloney, Pamela Rubin, Beena Desai, Maureen G. Richardson, Cynthia Bates, Darshana Parikh, Janice Prodell, Maddie Winters, Katherine Smith, Jeni Kwok, A. Cabrales, Ronke Adewale, Pam Melvin, Sadaf Shad, Katherine Siegel, Katherine Murkowski, Mary C. Kasch, Josey Hensley, Lisa Steele, Danielle Brown, Brian Burrows, Lauren Hlivka, Deana Rich, Amila Tutundzic, Tina Day, Lori Barganier, Ashley Wolfe, Mackenzie Little, Elyse Tomanio, Neha Patel, Diane Hession, Yamila Sierra, Rhonda Jones, Laura Benken, Jonathan Elmer, Subramanian Subramanian, Srikala Narayanan, Nicole Toney, Julia Wallace, Tami Echavarria Robinson, Andrew Frank, Stefan Blüml, Jessica L. Wisnowski, Keri Feldman, Avinash Vemulapalli, Linda Ryan, Scott Szypulski, Christopher B. Keys · 发表于：JAMA Network Open · 年份：2022 · DOI：10.1001/jamanetworkopen.2022.30518 · 被引用次数：39 · 研究领域：Cardiac Arrest and Resuscitation、S100 Proteins and Annexins、Traumatic Brain Injury and Neurovascular Disturbances

Importance: Families and clinicians have limited validated tools available to assist in estimating long-term outcomes early after pediatric cardiac arrest. Blood-based brain-specific biomarkers may be helpful tools to aid in outcome assessment. Objective: To analyze the association of blood-based brain injury biomarker concentrations with outcomes 1 year after pediatric cardiac arrest. Design, Setting, and Participants: The Personalizing Outcomes After Child Cardiac Arrest multicenter prospective cohort study was conducted in pediatric intensive care units at 14 academic referral centers in the US between May 16, 2017, and August 19, 2020, with the primary investigators blinded to 1-year outcomes. The study included 120 children aged 48 hours to 17 years who were resuscitated after cardiac arrest, had pre-cardiac arrest Pediatric Cerebral Performance Category scores of 1 to 3 points, and were admitted to an intensive care unit after cardiac arrest. Exposure: Cardiac arrest. Main Outcomes and Measures: The primary outcome was an unfavorable outcome (death or survival with a Vineland Adaptive Behavior Scales, third edition, score of <70 points) at 1 year after cardiac arrest. Glial fibrillary acidic protein (GFAP), ubiquitin carboxyl-terminal esterase L1 (UCH-L1), neurofilament light (NfL), and tau concentrations were measured in blood samples from days 1 to 3 after cardiac arrest. Multivariate logistic regression and area under the receiver operating characteristic curve (AURO...