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Relationships between markers of neurologic and endothelial injury during critical illness and long-term cognitive impairment and disability
Purpose Neurologic and endothelial injury biomarkers are associated with prolonged delirium during critical illness and may reflect injury pathways that lead to poor long-term outcomes. We hypothesized that blood–brain barrier (BBB), neuronal, and endothelial injury biomarkers measured during critic...
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| Published in: | Intensive care medicine 2018-03, Vol.44 (3), p.345-355 |
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| container_end_page | 355 |
| container_issue | 3 |
| container_start_page | 345 |
| container_title | Intensive care medicine |
| container_volume | 44 |
| creator | Hughes, Christopher G. Patel, Mayur B. Brummel, Nathan E. Thompson, Jennifer L. McNeil, J. Brennan Pandharipande, Pratik P. Jackson, James C. Chandrasekhar, Rameela Ware, Lorraine B. Ely, E. Wesley Girard, Timothy D. |
| description | Purpose
Neurologic and endothelial injury biomarkers are associated with prolonged delirium during critical illness and may reflect injury pathways that lead to poor long-term outcomes. We hypothesized that blood–brain barrier (BBB), neuronal, and endothelial injury biomarkers measured during critical illness are associated with cognitive impairment and disability after discharge.
Methods
We enrolled adults with respiratory failure and/or shock and measured plasma concentrations of BBB (S100B), neuronal (UCHL1, BDNF), and endothelial (E-selectin, PAI-1) injury markers within 72 h of ICU admission. At 3 and 12 months post-discharge, we assessed participants’ global cognition, executive function, and activities of daily living (ADL). We used multivariable regression to determine whether biomarkers were associated with outcomes after adjusting for relevant demographic and acute illness covariates.
Results
Our study included 419 survivors of critical illness with median age 59 years and APACHE II score 25. Higher S100B was associated with worse global cognition at 3 and 12 months (
P
= 0.008;
P
= 0.01). UCHL1 was nonlinearly associated with global cognition at 3 months (
P
= 0.02). Higher E-selectin was associated with worse global cognition (
P
= 0.006 at 3 months;
P
= 0.06 at 12 months). BDNF and PAI-1 were not associated with global cognition. No biomarkers were associated with executive function. Higher S100B (
P
= 0.05) and E-selectin (
P
= 0.02) were associated with increased disability in ADLs at 3 months.
Conclusions
S100B, a marker of BBB and/or astrocyte injury, and E-selectin, an adhesion molecule and marker of endothelial injury, are associated with long-term cognitive impairment after critical illness, findings that may reflect mechanisms of critical illness brain injury. |
| doi_str_mv | 10.1007/s00134-018-5120-1 |
| format | article |
| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5870884</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A724273258</galeid><sourcerecordid>A724273258</sourcerecordid><originalsourceid>FETCH-LOGICAL-c575t-d1e4e97bfe300a904ca2a785bdf68b841ec3b81d3f23e09782b553da096b1a093</originalsourceid><addsrcrecordid>eNp1kt2K1TAUhYsoznH0AbyRgDfedMxvm94Iw-AfDAii1yFNd3tyTJOatDOcd_ChTeeMM44cCSSw862Vnc0qipcEnxGM67cJY8J4iYksBaG4JI-KDeGMloQy-bjYYMZpyStOT4pnKe0yXVeCPC1OaCMoazDeFL--gtOzDT5t7ZRQC_M1gEejjj8gJhR65GGJwYXBGqR9h8B3Yd6Cs9oh63dL3KNuidYPyEQ7W7OWnfOQ0g3ugh_KGeKITBh8Bq4A2XHSNo7g5xuks0m31tl5_7x40muX4MXteVp8__D-28Wn8vLLx88X55elEbWYy44Ah6Zue2AY6wZzo6mupWi7vpKt5AQMayXpWE8Z4KaWtBWCdRo3VUvyzk6LdwffaWlH6EzuJGqnpmjzv_cqaKse3ni7VUO4UkLWWEqeDd7cGsTwc4E0q9EmA85pD2FJimJCG1JxVmX09T_oLizR5--tlOCSyrq5pwbtQFnfh_yuWU3VeU05rRkVMlPlEWoAD7nJ4KG3ufyAPzvC59XBaM1RATkITAwpRejvZkKwWiOnDpFTOXJqjZwiWfPq72HeKf5kLAP0AKRpzQnE-wn83_U3flDjcQ</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2015482879</pqid></control><display><type>article</type><title>Relationships between markers of neurologic and endothelial injury during critical illness and long-term cognitive impairment and disability</title><source>Springer Nature</source><creator>Hughes, Christopher G. ; Patel, Mayur B. ; Brummel, Nathan E. ; Thompson, Jennifer L. ; McNeil, J. Brennan ; Pandharipande, Pratik P. ; Jackson, James C. ; Chandrasekhar, Rameela ; Ware, Lorraine B. ; Ely, E. Wesley ; Girard, Timothy D.</creator><creatorcontrib>Hughes, Christopher G. ; Patel, Mayur B. ; Brummel, Nathan E. ; Thompson, Jennifer L. ; McNeil, J. Brennan ; Pandharipande, Pratik P. ; Jackson, James C. ; Chandrasekhar, Rameela ; Ware, Lorraine B. ; Ely, E. Wesley ; Girard, Timothy D.</creatorcontrib><description>Purpose
Neurologic and endothelial injury biomarkers are associated with prolonged delirium during critical illness and may reflect injury pathways that lead to poor long-term outcomes. We hypothesized that blood–brain barrier (BBB), neuronal, and endothelial injury biomarkers measured during critical illness are associated with cognitive impairment and disability after discharge.
Methods
We enrolled adults with respiratory failure and/or shock and measured plasma concentrations of BBB (S100B), neuronal (UCHL1, BDNF), and endothelial (E-selectin, PAI-1) injury markers within 72 h of ICU admission. At 3 and 12 months post-discharge, we assessed participants’ global cognition, executive function, and activities of daily living (ADL). We used multivariable regression to determine whether biomarkers were associated with outcomes after adjusting for relevant demographic and acute illness covariates.
Results
Our study included 419 survivors of critical illness with median age 59 years and APACHE II score 25. Higher S100B was associated with worse global cognition at 3 and 12 months (
P
= 0.008;
P
= 0.01). UCHL1 was nonlinearly associated with global cognition at 3 months (
P
= 0.02). Higher E-selectin was associated with worse global cognition (
P
= 0.006 at 3 months;
P
= 0.06 at 12 months). BDNF and PAI-1 were not associated with global cognition. No biomarkers were associated with executive function. Higher S100B (
P
= 0.05) and E-selectin (
P
= 0.02) were associated with increased disability in ADLs at 3 months.
Conclusions
S100B, a marker of BBB and/or astrocyte injury, and E-selectin, an adhesion molecule and marker of endothelial injury, are associated with long-term cognitive impairment after critical illness, findings that may reflect mechanisms of critical illness brain injury.</description><identifier>ISSN: 0342-4642</identifier><identifier>ISSN: 1432-1238</identifier><identifier>EISSN: 1432-1238</identifier><identifier>DOI: 10.1007/s00134-018-5120-1</identifier><identifier>PMID: 29523900</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Activities of Daily Living ; Adult ; Adults ; Aged ; Anesthesiology ; Biomarkers ; Blood-brain barrier ; Brain ; Brain injury ; Brain-derived neurotrophic factor ; Cognition ; Cognition & reasoning ; Cognition Disorders ; Cognitive ability ; Cognitive Dysfunction ; Critical Care Medicine ; Critical Illness ; Delirium ; Demographics ; Discharge ; E-selectin ; E-Selectin - analysis ; Emergency Medicine ; Endothelium ; Endothelium - injuries ; Ethylenediaminetetraacetic acid ; Executive function ; Head injuries ; Humans ; Illnesses ; Impairment ; Injuries ; Intensive ; Intensive care ; Male ; Medical research ; Medicine ; Medicine & Public Health ; Medicine, Experimental ; Mental disorders ; Middle Aged ; Neurons ; Original ; Pain Medicine ; Pediatrics ; Pneumology/Respiratory System ; Prospective Studies ; S100 Calcium Binding Protein beta Subunit - analysis ; S100b protein</subject><ispartof>Intensive care medicine, 2018-03, Vol.44 (3), p.345-355</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature and ESICM 2018</rights><rights>COPYRIGHT 2018 Springer</rights><rights>Intensive Care Medicine is a copyright of Springer, (2018). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c575t-d1e4e97bfe300a904ca2a785bdf68b841ec3b81d3f23e09782b553da096b1a093</citedby><cites>FETCH-LOGICAL-c575t-d1e4e97bfe300a904ca2a785bdf68b841ec3b81d3f23e09782b553da096b1a093</cites><orcidid>0000-0003-4797-5123</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29523900$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hughes, Christopher G.</creatorcontrib><creatorcontrib>Patel, Mayur B.</creatorcontrib><creatorcontrib>Brummel, Nathan E.</creatorcontrib><creatorcontrib>Thompson, Jennifer L.</creatorcontrib><creatorcontrib>McNeil, J. Brennan</creatorcontrib><creatorcontrib>Pandharipande, Pratik P.</creatorcontrib><creatorcontrib>Jackson, James C.</creatorcontrib><creatorcontrib>Chandrasekhar, Rameela</creatorcontrib><creatorcontrib>Ware, Lorraine B.</creatorcontrib><creatorcontrib>Ely, E. Wesley</creatorcontrib><creatorcontrib>Girard, Timothy D.</creatorcontrib><title>Relationships between markers of neurologic and endothelial injury during critical illness and long-term cognitive impairment and disability</title><title>Intensive care medicine</title><addtitle>Intensive Care Med</addtitle><addtitle>Intensive Care Med</addtitle><description>Purpose
Neurologic and endothelial injury biomarkers are associated with prolonged delirium during critical illness and may reflect injury pathways that lead to poor long-term outcomes. We hypothesized that blood–brain barrier (BBB), neuronal, and endothelial injury biomarkers measured during critical illness are associated with cognitive impairment and disability after discharge.
Methods
We enrolled adults with respiratory failure and/or shock and measured plasma concentrations of BBB (S100B), neuronal (UCHL1, BDNF), and endothelial (E-selectin, PAI-1) injury markers within 72 h of ICU admission. At 3 and 12 months post-discharge, we assessed participants’ global cognition, executive function, and activities of daily living (ADL). We used multivariable regression to determine whether biomarkers were associated with outcomes after adjusting for relevant demographic and acute illness covariates.
Results
Our study included 419 survivors of critical illness with median age 59 years and APACHE II score 25. Higher S100B was associated with worse global cognition at 3 and 12 months (
P
= 0.008;
P
= 0.01). UCHL1 was nonlinearly associated with global cognition at 3 months (
P
= 0.02). Higher E-selectin was associated with worse global cognition (
P
= 0.006 at 3 months;
P
= 0.06 at 12 months). BDNF and PAI-1 were not associated with global cognition. No biomarkers were associated with executive function. Higher S100B (
P
= 0.05) and E-selectin (
P
= 0.02) were associated with increased disability in ADLs at 3 months.
Conclusions
S100B, a marker of BBB and/or astrocyte injury, and E-selectin, an adhesion molecule and marker of endothelial injury, are associated with long-term cognitive impairment after critical illness, findings that may reflect mechanisms of critical illness brain injury.</description><subject>Activities of Daily Living</subject><subject>Adult</subject><subject>Adults</subject><subject>Aged</subject><subject>Anesthesiology</subject><subject>Biomarkers</subject><subject>Blood-brain barrier</subject><subject>Brain</subject><subject>Brain injury</subject><subject>Brain-derived neurotrophic factor</subject><subject>Cognition</subject><subject>Cognition & reasoning</subject><subject>Cognition Disorders</subject><subject>Cognitive ability</subject><subject>Cognitive Dysfunction</subject><subject>Critical Care Medicine</subject><subject>Critical Illness</subject><subject>Delirium</subject><subject>Demographics</subject><subject>Discharge</subject><subject>E-selectin</subject><subject>E-Selectin - analysis</subject><subject>Emergency Medicine</subject><subject>Endothelium</subject><subject>Endothelium - injuries</subject><subject>Ethylenediaminetetraacetic acid</subject><subject>Executive function</subject><subject>Head injuries</subject><subject>Humans</subject><subject>Illnesses</subject><subject>Impairment</subject><subject>Injuries</subject><subject>Intensive</subject><subject>Intensive care</subject><subject>Male</subject><subject>Medical research</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Medicine, Experimental</subject><subject>Mental disorders</subject><subject>Middle Aged</subject><subject>Neurons</subject><subject>Original</subject><subject>Pain Medicine</subject><subject>Pediatrics</subject><subject>Pneumology/Respiratory System</subject><subject>Prospective Studies</subject><subject>S100 Calcium Binding Protein beta Subunit - analysis</subject><subject>S100b protein</subject><issn>0342-4642</issn><issn>1432-1238</issn><issn>1432-1238</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp1kt2K1TAUhYsoznH0AbyRgDfedMxvm94Iw-AfDAii1yFNd3tyTJOatDOcd_ChTeeMM44cCSSw862Vnc0qipcEnxGM67cJY8J4iYksBaG4JI-KDeGMloQy-bjYYMZpyStOT4pnKe0yXVeCPC1OaCMoazDeFL--gtOzDT5t7ZRQC_M1gEejjj8gJhR65GGJwYXBGqR9h8B3Yd6Cs9oh63dL3KNuidYPyEQ7W7OWnfOQ0g3ugh_KGeKITBh8Bq4A2XHSNo7g5xuks0m31tl5_7x40muX4MXteVp8__D-28Wn8vLLx88X55elEbWYy44Ah6Zue2AY6wZzo6mupWi7vpKt5AQMayXpWE8Z4KaWtBWCdRo3VUvyzk6LdwffaWlH6EzuJGqnpmjzv_cqaKse3ni7VUO4UkLWWEqeDd7cGsTwc4E0q9EmA85pD2FJimJCG1JxVmX09T_oLizR5--tlOCSyrq5pwbtQFnfh_yuWU3VeU05rRkVMlPlEWoAD7nJ4KG3ufyAPzvC59XBaM1RATkITAwpRejvZkKwWiOnDpFTOXJqjZwiWfPq72HeKf5kLAP0AKRpzQnE-wn83_U3flDjcQ</recordid><startdate>20180301</startdate><enddate>20180301</enddate><creator>Hughes, Christopher G.</creator><creator>Patel, Mayur B.</creator><creator>Brummel, Nathan E.</creator><creator>Thompson, Jennifer L.</creator><creator>McNeil, J. Brennan</creator><creator>Pandharipande, Pratik P.</creator><creator>Jackson, James C.</creator><creator>Chandrasekhar, Rameela</creator><creator>Ware, Lorraine B.</creator><creator>Ely, E. Wesley</creator><creator>Girard, Timothy D.</creator><general>Springer Berlin Heidelberg</general><general>Springer</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-4797-5123</orcidid></search><sort><creationdate>20180301</creationdate><title>Relationships between markers of neurologic and endothelial injury during critical illness and long-term cognitive impairment and disability</title><author>Hughes, Christopher G. ; Patel, Mayur B. ; Brummel, Nathan E. ; Thompson, Jennifer L. ; McNeil, J. Brennan ; Pandharipande, Pratik P. ; Jackson, James C. ; Chandrasekhar, Rameela ; Ware, Lorraine B. ; Ely, E. Wesley ; Girard, Timothy D.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c575t-d1e4e97bfe300a904ca2a785bdf68b841ec3b81d3f23e09782b553da096b1a093</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Activities of Daily Living</topic><topic>Adult</topic><topic>Adults</topic><topic>Aged</topic><topic>Anesthesiology</topic><topic>Biomarkers</topic><topic>Blood-brain barrier</topic><topic>Brain</topic><topic>Brain injury</topic><topic>Brain-derived neurotrophic factor</topic><topic>Cognition</topic><topic>Cognition & reasoning</topic><topic>Cognition Disorders</topic><topic>Cognitive ability</topic><topic>Cognitive Dysfunction</topic><topic>Critical Care Medicine</topic><topic>Critical Illness</topic><topic>Delirium</topic><topic>Demographics</topic><topic>Discharge</topic><topic>E-selectin</topic><topic>E-Selectin - analysis</topic><topic>Emergency Medicine</topic><topic>Endothelium</topic><topic>Endothelium - injuries</topic><topic>Ethylenediaminetetraacetic acid</topic><topic>Executive function</topic><topic>Head injuries</topic><topic>Humans</topic><topic>Illnesses</topic><topic>Impairment</topic><topic>Injuries</topic><topic>Intensive</topic><topic>Intensive care</topic><topic>Male</topic><topic>Medical research</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Medicine, Experimental</topic><topic>Mental disorders</topic><topic>Middle Aged</topic><topic>Neurons</topic><topic>Original</topic><topic>Pain Medicine</topic><topic>Pediatrics</topic><topic>Pneumology/Respiratory System</topic><topic>Prospective Studies</topic><topic>S100 Calcium Binding Protein beta Subunit - analysis</topic><topic>S100b protein</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hughes, Christopher G.</creatorcontrib><creatorcontrib>Patel, Mayur B.</creatorcontrib><creatorcontrib>Brummel, Nathan E.</creatorcontrib><creatorcontrib>Thompson, Jennifer L.</creatorcontrib><creatorcontrib>McNeil, J. Brennan</creatorcontrib><creatorcontrib>Pandharipande, Pratik P.</creatorcontrib><creatorcontrib>Jackson, James C.</creatorcontrib><creatorcontrib>Chandrasekhar, Rameela</creatorcontrib><creatorcontrib>Ware, Lorraine B.</creatorcontrib><creatorcontrib>Ely, E. Wesley</creatorcontrib><creatorcontrib>Girard, Timothy D.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health Medical collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Intensive care medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hughes, Christopher G.</au><au>Patel, Mayur B.</au><au>Brummel, Nathan E.</au><au>Thompson, Jennifer L.</au><au>McNeil, J. Brennan</au><au>Pandharipande, Pratik P.</au><au>Jackson, James C.</au><au>Chandrasekhar, Rameela</au><au>Ware, Lorraine B.</au><au>Ely, E. Wesley</au><au>Girard, Timothy D.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Relationships between markers of neurologic and endothelial injury during critical illness and long-term cognitive impairment and disability</atitle><jtitle>Intensive care medicine</jtitle><stitle>Intensive Care Med</stitle><addtitle>Intensive Care Med</addtitle><date>2018-03-01</date><risdate>2018</risdate><volume>44</volume><issue>3</issue><spage>345</spage><epage>355</epage><pages>345-355</pages><issn>0342-4642</issn><issn>1432-1238</issn><eissn>1432-1238</eissn><abstract>Purpose
Neurologic and endothelial injury biomarkers are associated with prolonged delirium during critical illness and may reflect injury pathways that lead to poor long-term outcomes. We hypothesized that blood–brain barrier (BBB), neuronal, and endothelial injury biomarkers measured during critical illness are associated with cognitive impairment and disability after discharge.
Methods
We enrolled adults with respiratory failure and/or shock and measured plasma concentrations of BBB (S100B), neuronal (UCHL1, BDNF), and endothelial (E-selectin, PAI-1) injury markers within 72 h of ICU admission. At 3 and 12 months post-discharge, we assessed participants’ global cognition, executive function, and activities of daily living (ADL). We used multivariable regression to determine whether biomarkers were associated with outcomes after adjusting for relevant demographic and acute illness covariates.
Results
Our study included 419 survivors of critical illness with median age 59 years and APACHE II score 25. Higher S100B was associated with worse global cognition at 3 and 12 months (
P
= 0.008;
P
= 0.01). UCHL1 was nonlinearly associated with global cognition at 3 months (
P
= 0.02). Higher E-selectin was associated with worse global cognition (
P
= 0.006 at 3 months;
P
= 0.06 at 12 months). BDNF and PAI-1 were not associated with global cognition. No biomarkers were associated with executive function. Higher S100B (
P
= 0.05) and E-selectin (
P
= 0.02) were associated with increased disability in ADLs at 3 months.
Conclusions
S100B, a marker of BBB and/or astrocyte injury, and E-selectin, an adhesion molecule and marker of endothelial injury, are associated with long-term cognitive impairment after critical illness, findings that may reflect mechanisms of critical illness brain injury.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>29523900</pmid><doi>10.1007/s00134-018-5120-1</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0003-4797-5123</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0342-4642 |
| ispartof | Intensive care medicine, 2018-03, Vol.44 (3), p.345-355 |
| issn | 0342-4642 1432-1238 1432-1238 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5870884 |
| source | Springer Nature |
| subjects | Activities of Daily Living Adult Adults Aged Anesthesiology Biomarkers Blood-brain barrier Brain Brain injury Brain-derived neurotrophic factor Cognition Cognition & reasoning Cognition Disorders Cognitive ability Cognitive Dysfunction Critical Care Medicine Critical Illness Delirium Demographics Discharge E-selectin E-Selectin - analysis Emergency Medicine Endothelium Endothelium - injuries Ethylenediaminetetraacetic acid Executive function Head injuries Humans Illnesses Impairment Injuries Intensive Intensive care Male Medical research Medicine Medicine & Public Health Medicine, Experimental Mental disorders Middle Aged Neurons Original Pain Medicine Pediatrics Pneumology/Respiratory System Prospective Studies S100 Calcium Binding Protein beta Subunit - analysis S100b protein |
| title | Relationships between markers of neurologic and endothelial injury during critical illness and long-term cognitive impairment and disability |
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