(885) CNS Injury Biomarkers Are Elevated in Children After Cardiopulmonary Bypass Surgery

Introduction: Biomarker proteins resulting from neuronal, glial cell, and axonal injuries are widely used and have been extensively studied as an objective measure of cerebral insult in neonatal and pediatric brain injury such as hypoxic-ischemic encephalopathy, stroke, and traumatic brain injury. Few studies have investigated the use of such biomarkers in patients with Congenital Heart Disease (CHD) undergoing Cardiopulmonary bypass (CPB). As these biomarkers increase in response to brain injury after CPB, they could potentially be used to assess injury severity and outcome prediction.

Methods: Prospective, observational study that measured and analyzed serum levels of CNS-injury associated biomarkers p-Tau and UCHL-1 in 5 children with Congenital Heart Disease (CHD) 0-18 years of age, pre and immediately post Cardiopulmonary Bypass (CPB). The data was analyzed utilizing Prism 9 software.

Results: Our research has shown that p-Tau and UCHL-1 are elevated in pediatric patients immediately after CPB compared to their levels before surgery, AUC: 0.92, STD: 0.092, CI 95%: 0.73 to 1, p-value: 0.0283 for p-Tau and an AUC 0.84, STD: 0.150, CI 95%: 0.54 to 1, p-value: 0.0758 for UCHL-1.

Conclusions: Our data demonstrates that serum levels of p-Tau and UCHL-1 in children with CHD after CPB are elevated compared to baseline levels pre-bypass, suggesting a potential cerebral insult and disruption of the blood-brain barrier following CPB.