• J Trauma · Oct 2011

    Dynamics of glial fibrillary acidic protein during traumatic brain injury in children.

    • Jiří Zurek and Michal Fedora.
    • Department of Anesthesia and Intensive Care, University Children's Hospital, Brno, Czech Republic. jzurek@fnbrno.cz
    • J Trauma. 2011 Oct 1;71(4):854-9.

    BackgroundsGlial fibrillary acidic protein (GFAP) is a monomeric intermediate filament protein found in the astroglial cytoskeleton and is not found outside the central nervous system. It is a brain-specific protein that is released after traumatic brain injury (TBI).MethodsThis prospective study enrolled 59 children who had TBI, as verified by computed tomography. Daily GFAP measurement began at admission (<12 hours after trauma) and continued for 6 days. Blood samples were analyzed for GFAP by enzyme-linked immunosorbent assay. Outcome was assessed using the Glasgow Outcome Scale (GOS) at 6 months after injury.ResultsThe median serum levels of GFAP at admission were 7.47 ng/mL in patients who died, compared with 0.12 ng/mL in patients who survived (p=0.002). GFAP levels were significantly higher in patients who had a poor outcome 6 months after injury than in those who were alive or had good outcome (p<0.001). The area under the receiver operating characteristic curve for GFAP was 0.833 for day 0 and 0.884 for day 2.ConclusionsThese results suggest that determination of serum levels of GFAP may add to the clinical assessment of the primary damage and prediction of outcome after severe TBI.

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