TY - JOUR
T1 - Elevated S100B urine levels predict seizures in infants complicated by perinatal asphyxia and undergoing therapeutic hypothermia
AU - Bersani, Iliana
AU - Lapergola, Giuseppe
AU - Patacchiola, Roberta
AU - D'Adamo, Ebe
AU - Stuppia, Liborio
AU - de Laurenzi, Vincenzo
AU - Damiani, Verena
AU - Cataldo, Ivana
AU - Clemente, Katia
AU - Primavera, Adele
AU - Salomone, Rita
AU - Barbante, Elisabetta
AU - Campi, Francesca
AU - Savarese, Immacolata
AU - Ronci, Sara
AU - Dotta, Andrea
AU - Braguglia, Annabella
AU - Longo, Daniela
AU - Gavilanes, Danilo A. W.
AU - Gazzolo, Francesca
AU - Serpero, Laura
AU - Strozzi, Maria Chiara
AU - Maconi, Antonio
AU - Cassinari, Maurizio
AU - Libener, Roberta
AU - Gazzolo, Diego
PY - 2024/5/1
Y1 - 2024/5/1
N2 - Objectives: Seizures (SZ) are one of the main complications occurring in infants undergoing therapeutic hypothermia (TH) due to perinatal asphyxia (PA) and hypoxic ischemic encephalopathy (HIE). Phenobarbital (PB) is the first-line therapeutic strategy, although data on its potential side-effects need elucidation. We investigated whether: i) PB administration in PA-HIE TH-treated infants affects S100B urine levels, and ii) S100B could be a reliable early predictor of SZ. Methods: We performed a prospective case-control study in 88 PA-HIE TH infants, complicated (n=44) or not (n=44) by SZ requiring PB treatment. S100B urine levels were measured at 11 predetermined monitoring time-points from first void up to 96-h from birth. Standard-of-care monitoring parameters were also recorded. Results: S100B significantly increased in the first 24-h independently from HIE severity in the cases who later developed SZ and requested PB treatment. ROC curve analysis showed that S100B, as SZ predictor, at a cut-off of 2.78 μg/L achieved a sensitivity/specificity of 63 and 84 %, positive/negative predictive values of 83 and 64 %. Conclusions: The present results offer additional support to the usefulness of S100B as a trustable diagnostic tool in the clinical daily monitoring of therapeutic and pharmacological procedures in infants complicated by PA-HIE.
AB - Objectives: Seizures (SZ) are one of the main complications occurring in infants undergoing therapeutic hypothermia (TH) due to perinatal asphyxia (PA) and hypoxic ischemic encephalopathy (HIE). Phenobarbital (PB) is the first-line therapeutic strategy, although data on its potential side-effects need elucidation. We investigated whether: i) PB administration in PA-HIE TH-treated infants affects S100B urine levels, and ii) S100B could be a reliable early predictor of SZ. Methods: We performed a prospective case-control study in 88 PA-HIE TH infants, complicated (n=44) or not (n=44) by SZ requiring PB treatment. S100B urine levels were measured at 11 predetermined monitoring time-points from first void up to 96-h from birth. Standard-of-care monitoring parameters were also recorded. Results: S100B significantly increased in the first 24-h independently from HIE severity in the cases who later developed SZ and requested PB treatment. ROC curve analysis showed that S100B, as SZ predictor, at a cut-off of 2.78 μg/L achieved a sensitivity/specificity of 63 and 84 %, positive/negative predictive values of 83 and 64 %. Conclusions: The present results offer additional support to the usefulness of S100B as a trustable diagnostic tool in the clinical daily monitoring of therapeutic and pharmacological procedures in infants complicated by PA-HIE.
KW - perinatal asphyxia
KW - seizures
KW - phenobarbital
KW - hypothermia
KW - S100B
KW - HYPOXIC-ISCHEMIC ENCEPHALOPATHY
KW - WHITE-MATTER INJURY
KW - PROTEIN CONCENTRATIONS
KW - EARLY IDENTIFICATION
KW - NEONATAL SEIZURES
KW - PRETERM INFANTS
KW - BRAIN-DAMAGE
KW - BLOOD S100B
KW - CORD BLOOD
KW - BIOMARKERS
U2 - 10.1515/cclm-2023-1471
DO - 10.1515/cclm-2023-1471
M3 - Article
SN - 1434-6621
VL - 62
SP - 1109
EP - 1117
JO - Clinical Chemistry and Laboratory Medicine
JF - Clinical Chemistry and Laboratory Medicine
IS - 6
ER -