The serum biomarkers NSE and S100B predict intracranial complications and in-hospital survival in patients undergoing veno-venous ECMO.

Publisher: Nature Publishing Group Country of Publication: England NLM ID: 101563288 Publication Model: Electronic Cited Medium: Internet ISSN: 2045-2322 (Electronic) Linking ISSN: 20452322 NLM ISO Abbreviation: Sci Rep Subsets: MEDLINE

Original Publication: London : Nature Publishing Group, copyright 2011-

Extracorporeal Membrane Oxygenation*/adverse effects ; S100 Calcium Binding Protein beta Subunit*/blood ; Phosphopyruvate Hydratase*/blood ; Biomarkers*/blood; Humans ; Male ; Female ; Middle Aged ; Retrospective Studies ; Adult ; Prognosis ; Aged ; Hospital Mortality

Neurological complications in patients undergoing veno-venous extracorporeal membrane oxygenation (V-V ECMO) are challenging, with new intracranial pathologies posing a grave risk. We aimed to evaluate the utility of neuron-specific enolase (NSE) and S100B biomarkers for predicting outcomes in new-onset intracranial pathology during V-V ECMO. A retrospective analysis spanning 2013-2021 at a German university hospital was conducted. Cases with electronically available data on NSE and S100B serum levels, new intracranial pathologies (intracerebral hemorrhage [ICH], subarachnoid hemorrhage [SAH], cerebral ischemia, hypoxic-ischemic encephalopathy [HIE]), and survival during or after V-V ECMO were screened. The primary objective was to assess the prognostic value of NSE and S100B for in-hospital survival during V-V ECMO. Secondary objectives included analyzing clinical characteristics, outcome parameters, and biomarker distribution in V-V ECMO patients. Additionally, the prognostic value of NSE and S100B for in-hospital death and occurrence of intracranial pathology was calculated. Among 744 ECMO recipients, 426 underwent V-V ECMO. No significant differences in disease severity or organ failure scores were observed between groups, except for SAPS at discharge, which was higher in patients with new intracranial pathologies. Patients with new intracranial pathologies had lower median survival and higher in-hospital mortality. Weaning success from ECMO was also significantly reduced in these patients. Cut-off values of 58.4 µg/lfor NSE and 1.52 µg/l for S100B were associated with detrimental outcomes, characterized by significantly reduced median survival. A significant difference in maximum serum NSE concentration was found between patients with and without new intracranial pathology. All screened cases with new intracranial pathology had an unfavorable neurological outcome (modified Rankin Score [mRS] > 3) at discharge, with a higher proportion having an mRS of 6 in the high NSE group. The emergence of intracranial pathology during V-V ECMO significantly increases the risk of death. Changes in NSE and S100B levels serve as valuable follow-up parameters for predicting new intracranial pathology and survival during V-V ECMO therapy.
Competing Interests: Declarations. Ethics approval and consent to participate: Ethical approval for our study was provided by the Ethic Committee (No. 492/20) of the University Hospital Bonn, Germany and the need for informed consent was waived. Research was performed in accordance with the Declaration of Helsinki. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.
(© 2024. The Author(s).)

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01ZZ18030Q German Federal Ministry of Education and Research (BMBF)

0 (S100 Calcium Binding Protein beta Subunit)
EC 4.2.1.11 (Phosphopyruvate Hydratase)
0 (S100B protein, human)
0 (Biomarkers)
EC 4.2.1.11 (ENO2 protein, human)

Date Created: 20241218 Date Completed: 20241218 Latest Revision: 20250104

20250104

PMC11655984

10.1038/s41598-024-82898-3

39695311