• Johan Undén, Ramona Astrand, Knut Waterloo, Tor Ingebrigtsen, Johan Bellner, Peter Reinstrup, Gunnar Andsberg, and Bertil Romner.
• Department of Anaesthesiology and Intensive Care, Halmstad Regional Hospital, Halmstad, and Neurointensive Care Unit, Department of Neurosurgery, Lund University Hospital, Sweden. johan.unden@med.lu.se
• Neurocrit Care. 2007 Jan 1; 6 (2): 94-9.

ObjectiveS100B is viewed as the most promising biomarker for brain damage. It has been proposed that this marker is useful in a Neurointensive Care Unit (NICU) as a monitoring parameter. This study aims to examine the clinical usefulness of daily serum S100B measurements in this setting.DesignProspective consecutive inclusion of patients.PatientsA total of 79 patients with confirmed or suspected head injury or cerebrovascular insults (CVIs) (based upon patient history, computed tomography (CT) and/or magnetic resonance imaging (MRI) and neurological examination including coma scoring) who required neurointensive care were included in the study.InterventionsSampling for S100B was performed at admission and daily until patients were discharged from the NICU. S100B measurements were statistically compared to occurrence of secondary complications and outcome according to Glasgow Outcome Scale (GOS), with focus on clinical prediction.Measurements And Main Results17 of 79 patients (22%) had secondary neurological complications. Mean S100B levels were found to be an independent parameter associated with these complications (P=0.03). Mean S100B levels were higher in patients with complications compared to those without on both the complication day (P=0.033) and the day after (P=0.015), but not the day prior to the complication (P=0.62). S100B did not predict secondary neurological complication. Neither mean (P=0.182) nor peak (P=0.370) S100B levels were associated with or predicted outcome according to dichotomised GOS.ConclusionDaily S100B measurements are associated with secondary complications but not to outcome. However, daily S100B levels do not predict secondary complications, which limit the usefulness of this brain biomarker in this setting.

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