Prehospital Emergency Medical Services, Research and Development, Central Denmark Region, Aarhus, Denmark.
Department of Anesthesiology, Section North, Aarhus University Hospital, Central Denmark Region, Aarhus, Denmark.
J Neurotrauma. 2020 Sep 1;37(17):1864-1869. doi: 10.1089/neu.2019.6907. Epub 2020 May 4.
According to in-hospital guidelines, the biomarker, S100 calcium-binding protein B (S100B), is used to rule out intracranial lesions in mild-moderate traumatic brain injury (TBI). It is currently investigated whether S100B is applicable in a pre-hospital setting. The aim was to compare S100B values and hemolysis index in blood samples drawn and stored under simulated pre-hospital conditions to standardized blood samples. Thirty patients undergoing craniotomy at Department of Neurosurgery, Aarhus University Hospital (Aarhus, Denmark) each had six blood samples drawn. Two samples, drawn in in-hospital standardized Beckton Dickinson tubes and pre-hospital Monovette tubes, respectively, were stored as references at 21°C for 30 min. Two samples were stored at 15°C and 29°C, respectively, one sample was stored at prolonged time (60 min), and one sample was transported for 30 min before centrifugation. S100B values were compared by equivalence test with a pre-defined equivalence margin of ±8.5%. There was no clinically relevant difference between samples stored in different tubes, at various temperatures, or time to analysis compared to reference samples. Transported samples had an 11.5% (90% confidence interval [CI], 6.55; 16.61) higher median S100B value and a 430% (95% CI, 279.6; 661.4) higher median hemolysis index compared to reference samples. Three of 30 (10%) patients had an S100B value above guideline cutoff in the transported sample, which was not found in reference samples (false positive). There were no false negatives. In conclusion, S100B values were not influenced by different tubes, temperatures, and time to analysis. Transported samples had higher median S100B values and hemolysis, icterus, and lipemia index compared to reference samples.
根据院内指南，生物标志物 S100 钙结合蛋白 B（S100B）用于排除轻度至中度创伤性脑损伤（TBI）中的颅内病变。目前正在研究 S100B 是否适用于院前环境。目的是比较在模拟院前条件下采集和储存的血液样本与标准化血液样本的 S100B 值和溶血指数。在丹麦奥胡斯大学医院神经外科接受开颅手术的 30 名患者每人抽取了 6 份血样。两个样本分别取自院内标准化贝克顿·迪金森管和院前 Monovette 管，在 21°C 下储存 30 分钟作为参考。两个样本分别在 15°C 和 29°C 下储存，一个样本储存时间延长（60 分钟），一个样本在离心前运输 30 分钟。通过等价检验比较 S100B 值，预定义的等价范围为±8.5%。与参考样本相比，储存在不同管中、不同温度下或分析时间不同的样本之间没有临床相关差异。运输样本的 S100B 值中位数比参考样本高 11.5%（90%置信区间 [CI]，6.55；16.61），溶血指数中位数高 430%（95%CI，279.6；661.4）。30 名患者中有 3 名（10%）在运输样本中 S100B 值高于指南截止值，而在参考样本中未发现（假阳性）。没有假阴性。结论是，不同的管、温度和分析时间都不会影响 S100B 值。与参考样本相比，运输样本的 S100B 值和溶血值中位数更高，黄疸、脂血指数也更高。
