Time-dependent responses of brain injury biomarkers after severe cerebral desaturation in paediatric patients during cardiac surgery with cardiopulmonary bypass: a single-centre observational cohort study

作者：Zeng‐Chun Wang, Xiang Lin, Ling‐Shan Yu, Qi‐Liang Zhang, Ye Chen, W J Chen · 发表于：Frontiers in Cardiovascular Medicine · 年份：2026 · DOI：10.3389/fcvm.2026.1879937 · 研究领域：Cardiac and Coronary Surgery Techniques、S100 Proteins and Annexins、Sepsis Diagnosis and Treatment

Background Neurological injury remains an important concern in paediatric patients after congenital heart disease (CHD) surgery with cardiopulmonary bypass (CPB). Regional cerebral oxygen saturation (rScO 2 ) can be used to identify unstable intraoperative cerebral oxygenation, but its association with the postoperative responses of brain injury biomarkers remains unclear. Methods This single-centre observational cohort study included 104 children who underwent congenital heart surgery with CPB. The maximum intraoperative decrease in rScO 2 was calculated as the preoperative value minus the lowest value recorded during bypass, during aortic cross-clamping, or after the return of spontaneous circulation. Severe cerebral desaturation was defined as a decrease of at least 20%. The levels of inflammatory cytokines and biomarkers of brain injury were measured preoperatively and on postoperative Days 0 (POD0), POD1, and POD2. Postoperative changes were calculated as log 2 fold changes from baseline and z-standardized. The composite inflammation score derived from tumour necrosis factor-alpha (TNF-α), interleukin-1 beta (IL-1β), interleukin-6 (IL-6), and interleukin-8 (IL-8) levels, and the composite brain injury score derived from glial fibrillary acidic protein (GFAP), S100 calcium-binding protein B (S100B), and neuron-specific enolase (NSE) levels were averaged to derive the composite brain injury score. Adjusted associations were evaluated using multivariable linear regression m...