Prout Andrew J, Wolf Michael S, Fink Ericka L
Department of Critical Care Medicine, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, USA.
Curr Opin Pediatr. 2017 Jun;29(3):272-279. doi: 10.1097/MOP.0000000000000488.
Traumatic brain injury (TBI) and cardiac arrest are important causes of morbidity and mortality in children. Improved diagnosis and outcome prognostication using validated biomarkers could allow clinicians to better tailor therapies for optimal efficacy.
Contemporary investigation has yielded plentiful biomarker candidates of central nervous system (CNS) injury, including macromolecules, genetic, inflammatory, oxidative, and metabolic biomarkers. Biomarkers have yet to be validated and translated into bedside point-of-care or cost-effective and efficient laboratory tests. Validation testing should consider developmental status, injury mechanism, and time trajectory with patient-centered outcomes.
Recent investigation of biomarkers of CNS injury may soon improve diagnosis, management, and prognostication in children with traumatic brain injury and cardiac arrest.
创伤性脑损伤（TBI）和心脏骤停是儿童发病和死亡的重要原因。使用经过验证的生物标志物改善诊断和预后预测可以使临床医生更好地调整治疗方案以达到最佳疗效。
当代研究已产生了大量中枢神经系统（CNS）损伤的生物标志物候选物，包括大分子、基因、炎症、氧化和代谢生物标志物。生物标志物尚未经过验证并转化为床边即时检测或具有成本效益且高效的实验室检测。验证测试应考虑发育状态、损伤机制以及以患者为中心的结果的时间轨迹。
近期对中枢神经系统损伤生物标志物的研究可能很快会改善创伤性脑损伤和心脏骤停患儿的诊断、管理和预后预测。
