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Tau Is Elevated in Pediatric Patients on Extracorporeal Membrane Oxygenation.

体外膜肺氧合患儿 Tau 升高。

  • 影响因子:2.05
  • DOI:10.1097/MAT.0000000000000923
  • 作者列表:"Lee AE","Pandiyan P","Liu MM","Williams MA","Everett AD","Mueller GP","Morriss MC","Raman L","Carlson D","Gatson JW
  • 发表时间:2020-01-01
Abstract

Neurologic injury is a known and feared complication of extracorporeal membrane oxygenation (ECMO). Neurologic biomarkers may have a role in assisting in early identification of such. Axonal biomarker tau has not been investigated in the pediatric ECMO population. The objective of this study is to evaluate plasma levels of tau in pediatric patients supported with ECMO. Eighteen patients requiring ECMO support in a quaternary pediatric intensive care unit at a university-affiliated children's hospital from October 2015 to February 2017 were enrolled. Patients undergoing extracorporeal cardiopulmonary resuscitation or recent history of bypass were excluded. Plasma tau was measured using enzyme-linked immunosorbent assay. Neuroimaging was reviewed for acute neurologic injury, and tau levels were analyzed to assess for correlation. Tau was significantly higher in ECMO patients than in control subjects. Sixty-one percent of subjects had evidence of acute brain injury on neuroimaging, but tau level did not correlate with injury. Subjects with multifocal injury all experienced infarction and had significantly higher tau levels on ECMO day 3 than patients with isolated injury. In addition, peak tau levels of neuro-injured subjects were compared with controls and noninjured ECMO subjects using receiver operating curve analysis. This study demonstrates preliminary evidence of axonal injury in pediatric ECMO patients.

摘要

神经损伤是体外膜肺氧合 (ECMO) 已知且令人担忧的并发症。神经系统生物标志物可能在协助早期识别此类生物标志物方面发挥作用。轴突生物标志物 tau 尚未在儿科 ECMO 人群中进行研究。本研究的目的是评估 ECMO 支持的儿科患者血浆 tau 蛋白水平。入选 2015年10月至 2017年2月在大学附属儿童医院第四系儿科重症监护室需要 ECMO 支持的 18 例患者。接受体外心肺复苏或近期搭桥术史的患者被排除在外。采用酶联免疫吸附法测定血浆 tau 蛋白。回顾急性神经损伤的神经影像学,分析 tau 水平以评估相关性。ECMO 患者的 Tau 蛋白显著高于对照组。1% 的受试者在神经影像学上有急性脑损伤的证据,但 tau 水平与损伤无关。多灶性损伤的受试者都经历了梗死,在 ECMO 第 3 天 tau 水平显著高于孤立性损伤患者。此外,使用受试者工作曲线分析比较神经损伤受试者与对照组和非损伤 ECMO 受试者的 tau 峰水平。本研究证明了小儿 ECMO 患者轴索损伤的初步证据。

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发表时间:2020-01-29
DOI:10.1080/02770903.2020.1723622
作者列表:["Parlar-Chun R","Arnold K"]

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影响因子:2.40
发表时间:2020-02-02
来源期刊:BMC Pulmonary Medicine
DOI:10.1186/s12890-020-1056-7
作者列表:["Joon Young Choi","Jeong Uk Lim","Ho Jung Jeong","Ji Eun Lee","Chin Kook Rhee"]

METHODS:Abstract Background We investigated the association between a combination of two markers, peripheral (PEC) and bronchoalveolar lavage (BAL) eosinophil percentage (BEP), and oxygen requirements in patients with acute eosinophilic pneumonia (AEP). Methods We retrospectively reviewed the medical records of patients with AEP treated at the Armed Forces Capital Hospital between May 2012 and May 2017. We used correlation analyses to assess the association between PEC/BEP and clinical outcomes in AEP patients. Receiver operating characteristic (ROC) curve analyses were used to calculate the cut-off value for BEP that categorised patients requiring a significant oxygen supply. The BAL/blood eosinophil (BBE) score was introduced to stratify patients with peripheral eosinophilia and elevated BEP. Clinical characteristics and outcomes were compared between the different groups. Multiple logistic regression was performed for significant oxygen requirements using two different models using age, C-reactive protein (CRP), smoking duration, and BBE score (model 1) and age, CRP, BEP, and PEC (model 2). Results Among the 338 patients, 99.7% were male, and their mean age was 20.4 ± 1.4 years. Only 0.6% of patients were never smokers and the mean number of smoking days was 26.2 ± 25.4. Correlation analyses revealed that both the PaO2/FiO2 ratio and duration of oxygen supply were associated with BEP. ROC curve analyses indicated a cut-off level of 41.5%. Patients with a high BBE score had favourable outcomes in terms of hypoxemia, hospital days, intensive care unit admission, oxygen supply days, and steroid treatment days. Multiple logistic regression revealed that BEP and BBE score tended to be associated with significant oxygen requirements. Conclusions In this study, we revealed that both peripheral and BAL eosinophilia is associated with favourable outcomes in AEP patients.

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影响因子:2.41
发表时间:2020-01-22
DOI:10.1155/2020/9814916
作者列表:["Fei Zhao","Xuemei Guan","Jing Li","Liyong Liu","Jie Gong","Lihua He","Fanliang Meng","Jianzhong Zhang"]

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