TY - JOUR
T1 - A case series on the value of tau and neurofilament protein levels to predict and detect delirium in cardiac surgery patients
AU - Saller, Thomas
AU - Petzold, Axel
AU - Zetterberg, Henrik
AU - Kuhle, Jens
AU - Chappell, Daniel
AU - von Dossow, Vera
AU - Klawitter, Felix
AU - Schurholz, Tobias
AU - Hagl, Christian
AU - Reuter, Daniel A.
AU - Zwissler, Bernhard
AU - Ehler, Johannes
PY - 2019/1/1
Y1 - 2019/1/1
N2 - BACKGROUND: Delirium following cardiac surgery is a relevant complication in the majority of elderly patients but its prediction is challenging. Cardiopulmonary bypass, essential for many interventions in cardiac surgery, is responsible for a severe inflammatory response leading to neuroinflammation and subsequent delirium. Neurofilament light protein (NfL) and tau protein (tau) are specific biomarkers to detect neuroaxonal injury as well as glial fibrillary acidic protein (GFAP), a marker of astrocytic activation. METHODS: We thought to examine the perioperative course of these markers in a case series of each three cardiac surgery patients under off-pump cardiac arterial bypass without evolving delirium (OPCAB-NDEL), patients with a procedure under cardio-pulmonary bypass (CPB) without delirium (CPB-NDEL) and delirium after a CPB procedure (CPB-DEL). Delirium was diagnosed by the Confusion Assessment Method for the ICU and chart reviews. RESULTS: We observed increased preoperative levels of tau in patients with later delirium, whereas values of NfL and GFAP did not differ. In the postoperative course, all biomarkers increased multi-fold. NfL levels sharply increased in patients with CPB reaching the highest levels in the CPB-DEL group. CONCLUSION: Tau and NfL might be of benefit to identify patients in cardiac surgery at risk for delirium and to detect patients with the postoperative emergence of delirium.
AB - BACKGROUND: Delirium following cardiac surgery is a relevant complication in the majority of elderly patients but its prediction is challenging. Cardiopulmonary bypass, essential for many interventions in cardiac surgery, is responsible for a severe inflammatory response leading to neuroinflammation and subsequent delirium. Neurofilament light protein (NfL) and tau protein (tau) are specific biomarkers to detect neuroaxonal injury as well as glial fibrillary acidic protein (GFAP), a marker of astrocytic activation. METHODS: We thought to examine the perioperative course of these markers in a case series of each three cardiac surgery patients under off-pump cardiac arterial bypass without evolving delirium (OPCAB-NDEL), patients with a procedure under cardio-pulmonary bypass (CPB) without delirium (CPB-NDEL) and delirium after a CPB procedure (CPB-DEL). Delirium was diagnosed by the Confusion Assessment Method for the ICU and chart reviews. RESULTS: We observed increased preoperative levels of tau in patients with later delirium, whereas values of NfL and GFAP did not differ. In the postoperative course, all biomarkers increased multi-fold. NfL levels sharply increased in patients with CPB reaching the highest levels in the CPB-DEL group. CONCLUSION: Tau and NfL might be of benefit to identify patients in cardiac surgery at risk for delirium and to detect patients with the postoperative emergence of delirium.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85072716943&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/31530945
U2 - https://doi.org/10.5507/bp.2019.043
DO - https://doi.org/10.5507/bp.2019.043
M3 - Article
C2 - 31530945
SN - 1213-8118
VL - 163
SP - 241
EP - 246
JO - Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia
JF - Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia
IS - 3
ER -