Role of Biomarkers in Acute Brain Injury During ECMO Support

23 Mar 20264 min read0 viewsJournal Feed

GIST

Friedman and colleagues have reported the findings of a multicenter, prospective cohort study conducted from 2019 to 2023 and with 18-month follow-up in children (aged 2 days to <18 years), supported with extracorporeal membrane oxygenation (ECMO). The objectives of the study were to determine whether elevations of neurological-related plasma biomarkers could aid in the timely identification of acute brain injury (ABI) and to evaluate their association with short- and long-term clinical outcomes.

Glial fibrillary acid protein (GFAP), neurofilament light chain (NfL), and tau protein levels were assessed serially during ECMO support among 219 patients from 11 centers. The short-term unfavorable outcome was a composite of in-hospital mortality or discharge with favorable neurological condition (Pediatriac Cerebral Performance Category [PCPC] score ≥3, with decline of ≥1 point from baseline).

The unfavorable long-term outcome was a composite of mortality or Vineland Adaptive Behavior Scales (VABS) composite score less than 85 at 18 months after ECMO.

Clinical Editorial

Study framework and population

Multicenter, prospective cohort conducted from 2019–2023 with 18-month follow-up.
Participants: children aged 2 days to under 18 years supported on ECMO.
Enrolled across 11 centers, with serial biomarker measurements during ECMO.

Biomarker panel and aims

Investigated plasma levels of GFAP, NfL, and tau as potential early indicators of acute brain injury (ABI) during ECMO.
Primary goals were to determine whether elevations in these biomarkers facilitate timely ABI identification and to explore associations with short- and long-term outcomes.

Design and outcomes

219 patients with serial biomarker assessments.
Short-term unfavorable outcome defined as in-hospital mortality or discharge with a poor neurological status (PCPC ≥3 or a decline of ≥1 from baseline).
Long-term unfavorable outcome defined as mortality or VABS composite score <85 at 18 months post-ECMO.

Key contextual notes and limitations

The summary provided specifies study objectives, populations, and outcome definitions but does not report numerical results, effect sizes, or conclusions.