Abstract 13260: Glial Fibrillary Acidic Protein in Children With Congenital Heart Disease Undergoing Cardiopulmonary Bypass
Objective: to determine whether the brain-specific biomarker Glial Fibrillary Acidic Protein (GFAP) varies over time during cardiopulmonary bypass for repair of congenital heart disease.
Methods: prospective observational pilot study to characterize the trends in GFAP during bypass. Children <21 years old with congenital heart disease undergoing bypass for repair at the Johns Hopkins Hospital and Texas Children's Hospital were enrolled. Blood samples were collected during 4 phases: pre-bypass, cooling, re-warming, and post-bypass.
Results: Eighty-five patients were enrolled between October 2010-May 2011. Median age was 0.67 years (+ 5). Median weight was 7.02 Kg (+ 18.5). Single ventricle anatomy was present in 19 (22.4%). Mean GFAP values by phase were: pre-bypass 0.02 (+ 0.05), cooling 0.14 (+ 0.37), rewarming 0.39 (+ 0.71), post-bypass 0.20 (+ 0.46). There were significant elevations in GFAP from pre-bypass to all subsequent stages, with the greatest increase during re-warming (p=0.0001). Maximal GFAP levels were significantly related to younger age (p<0.001), lower weight (p<0.0001), and bypass time (p<0.01). Peak GFAP levels did not vary significantly in those with single ventricle anatomy versus two ventricular repairs.
Conclusions: This pilot study shows that there are significant increases in GFAP in children undergoing cardiopulmonary bypass for repair of CHD. The highest GFAP values were seen during rewarming. Elevations are significantly associated with younger age, lower weight and bypass time, all known risk factors for adverse neurocognitive outcomes. As GFAP is the most brain-specific biomarker identified to date, it may act as a rapid diagnostic marker of brain injury which will accelerate diagnosis and allow timely intervention in this high-risk population.
- © 2011 by American Heart Association, Inc.