The role of serum biomarkers as prognostic indicators in pediatric cardiac arrest: a systematic review

血清生物标志物在儿童心脏骤停预后指标中的作用:系统评价

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Abstract

PURPOSE: After Cardiac Arrest (CA), serum biomarkers (SB) are released to the blood in response to brain damage and, therefore, may be helpful tools to predict neurological outcome. This systematic review aims at assessing the role of SB as neurological outcome indicators after pediatric CA. METHODS: A systematic literature search was performed in PubMed, Scopus, WebOfScience and Cochrane Library. All information retrieved from the selected articles was summarized in a data table. RESULTS: Eight studies, including a total of 539 patients, were analyzed. Neurological outcomes were assessed by using the Pediatric Cerebral Performance Category (PCPC) scale in all studies except one. Eleven serum biomarkers were evaluated, with higher concentrations observed in the unfavorable outcome group at various time points. However, only one study defined a specific cutoff value. The biomarkers with the highest predictive accuracy for neurological outcomes appear to be initial levels of IL-17 and CNFT, as well as NSE and S100B. CONCLUSION: Following pediatric CA, SB may be helpful indicators of unfavorable neurological outcome, as they seem to appear in higher concentrations in this group. Further research is required to establish specific timepoints and cutoff values and to determine the implication of these findings in clinical practice.

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