Navigation Links
Protein found to predict brain injury in children on 'ECMO' life support
Date:11/22/2010

Johns Hopkins Children's Center scientists have discovered that high blood levels of a protein commonly found in the central nervous system can predict brain injury and death in critically ill children on a form of life support called extra-corporeal membrane oxygenation or ECMO.

ECMO, used to temporarily oxygenate the blood of patients whose heart and lungs are too weak or damaged to do so on their own, is most often used as a last resort because it can increase the risk for brain bleeding, brain swelling, stroke and death in some patients.

A detailed report of the Hopkins team's findings is published ahead of print Nov. 4 in the journal Pediatric Critical Care Medicine.

Following 22 ECMO patients, ranging from two days to 9 years of age, the researchers found that those with abnormally high levels of glial fibrillary acidic protein (GFAP) were 13 times more likely to die and 11 times more likely to suffer brain injury than children with normal GFAP levels. GFAP levels are already used as a marker of neurologic damage in adults who suffer strokes and traumatic brain injuries.

Although preliminary, the team's findings may pave the way to a much-needed way to monitor the precarious neurologic status of children on ECMO without using imaging tests like ultrasounds or CT scans. Periodic blood tests measuring GFAP levels may be one such tool to monitor brain function and help ward off brain injury and death, the researchers say.

"A simple, fast and easy-to-use test has been needed to monitor, predict and prevent brain damage in children on ECMO because these children are unresponsive or heavily sedated, and doctors cannot easily gauge their neurologic function," says study lead investigator Melania Bembea, M.D., M.P. H., a pediatric critical-care specialist at Hopkins Children's.

"Early detection of brain injury can help us prevent further harm by changing medication doses and rapidly weaning the patient from ECMO support," she adds.

The findings may have implications beyond ECMO, the researchers say, as they offer a way to monitor brain damage in other high-risk situations, including heart surgery and severely premature birth.

"Our long-term goal is to make lifesaving therapies like ECMO and heart surgery safer and more effective by improving protection of the brain, and GFAP and other biomarkers can give us a much-needed benchmark around which we can make these therapies safer," says senior investigator Allen Everett, M.D., a cardiologist at Hopkins Children's.

In the study, seven of the 22 children on ECMO developed brain bleeding or brain swelling, five of whom died subsequently. These children had much higher peak levels of GFAP than children without brain injury 5.9 nanograms per milliliter of blood compared to 0.09 in children without brain injury. GFAP levels were also markedly higher among eight of the 22 children in the study who had poor neurologic outcomes after ECMO (3.6 ng/ml) than in those children who had good neurologic outcomes (0.09 ng/ml).

Researchers also measured GFAP levels among healthy children and among newborns without neurologic injuries. Their median GFAP level was 0.055 nanograms per milliliter of blood and as high as 0.436 in some cases. By comparison, overall GFAP levels in children with neurologic injuries were 13 times greater than GFAP levels in healthy children.

The researchers caution that their findings should be replicated in a larger trial with more patients and that future studies must clarify the relationship between a rise in GFAP levels and the onset of brain injury. In the current study, GFAP levels rose sharply in some patients one or two days before their brain damage was discovered on ultrasound.

ECMO is used in about 1,000 children each year. Between 10 percent and 60 percent of children who survive ECMO suffer neurologic damage either because of their underlying disease or complications during ECMO therapy, the researchers say.

Hopkins Children's is Maryland's only hospital providing pediatric ECMO service.


'/>"/>

Contact: Ekaterina Pesheva
epeshev1@jhmi.edu
410-516-4996
Johns Hopkins Medical Institutions
Source:Eurekalert

Related medicine news :

1. Protein in the urine: A warning sign for cognitive decline
2. Scripps Research scientists identify first synthetic activator of 2 critical proteins
3. Scientists at IRB Barcelona and BSC publish the worlds largest video data bank of proteins
4. Protein Differences May Explain Long-Term HIV Control
5. Mouse model confirms mutated proteins role in dementia
6. The protein NOS2 isnt good for ER-negative breast cancer patients
7. Cell survival protein discovery rewrites immune system story
8. Parkinsons disease: Excess of special protein identified as key to symptoms and possible new target for treatment with widely used anti-cancer drug imatinib
9. C-Reactive Protein Levels Vary By Race: Study
10. Protein key to growth of pancreatic cancer
11. Nonstick coating of a protein found in semen reduces HIV infection
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:2/17/2017)... Tampa, FL (PRWEB) , ... February 17, 2017 ... ... a premier sponsor and exhibitor at Molecular Medicine Tri-Conference February 20 – 22 ... through Wednesday, Inspirata will showcase its anatomic and molecular pathology workflow solution, as ...
(Date:2/17/2017)... ... February 17, 2017 , ... Top neuroendocrine cancer doctors, nurses and specialists ... from February 21 - 23 in Beaver Creek, CO. It was announced today by ... second year in Beaver Creek, hosting over 60 faculty members and addressing unmet needs ...
(Date:2/17/2017)... FL (PRWEB) , ... February 17, 2017 , ... ... services and financial planning assistance to families and business owners in the greater ... LifeNet 4 Families organization. , For more than 30 years, LifeNet 4 ...
(Date:2/16/2017)... ... 17, 2017 , ... For some cancer survivors, the memories ... Physician researchers at The Marcus Institute of Integrative Health at Thomas Jefferson ... reducing symptoms of traumatic stress in cancer patients and published their results ...
(Date:2/16/2017)... ... 2017 , ... The Price Agency, a Jefferson County-based firm ... the Birmingham area, is announcing an ongoing charity event to help raise support ... son, Anius. , Anius is medically complex with diagnoses consisting and not limited ...
Breaking Medicine News(10 mins):
(Date:2/18/2017)... , Feb. 17, 2017   Parker ... protecting the rights of victims injured by medical ... regulators to call for better reporting. Congress required ... Safety concerns involving power morcellators and duodenoscopes ... to investigate how hospitals report injuries and deaths ...
(Date:2/17/2017)... February 17, 2017 Cryoablation, Electrical, Endometrial Hydrothermal, ... The global ablation technologies market is expected to grow at a ... The market is expected to grow at a CAGR of 9.5% ... 2016, and $9.05bn in 2026. ... How this report will benefit you Read on ...
(Date:2/17/2017)... 2017 Arvinas LLC, a private biotechnology company ... degradation, today announced the presentation of new preclinical data ... poster session at the American Society of Clinical Oncology ... Orlando, FL. "The new ... the potential of PROTACs to drive durable and robust ...
Breaking Medicine Technology: