Biochemical markers of brain injury: Can they point to a diagnosis?

摘要

In this issue of Pediatric Critical Care Medicine, Drs. Berger and Kochanek present preliminary findings on the level of S100B protein in the urine of critically ill infants and children suffering inflicted traumatic brain injury (TBI) or hypoxemic brain injury (HBI). Their principal conclusion is that the urinary test may assist with assessing prognosis. The authors also wonder whether the test might be of value in identifying patients who are victims of child abuse. The numbers in this study are small (nine children with HBI and six with inflicted TBI), and there areno controls with accidental (i.e., noninflicted)TBI. However, this work-particularly the authors' speculation-warrants closer consideration.