Changes in Plasma Glial Fibrillary Acidic Protein in Children Receiving Sevoflurane Anesthesia: A Preliminary Randomized Trial

We investigated changes in plasma glial fibrillary acidic protein concentration during sevoflurane anesthesia induction in children < 3 years old and determined the effect of co-administering dexmedetomidine. This preliminary randomized trial included 60 pediatric patients who received sevoflurane anesthesia for >3 h. Patients were assigned to dexmedetomidine or control groups at a 1:1 ratio. The primary outcome was changes in plasma glial fibrillary acidic protein concentration of dexmedetomidine and control groups over time. Fifty-five patients were included in the final analysis. The median (interquartile range (IQR)) of the plasma glial fibrillary acidic protein level was 387.7 (298.9–510.8) pg·mL−1 immediately after anesthetic induction, 302.6 (250.9–412.5) pg·mL−1 at 30 min, and 321.9 (233.8–576.2) pg·mL−1 at 180 min after the first sample. These values did not change over time (p = 0.759). However, plasma glial fibrillary acidic protein increased after 180 min of infusion of dexmedetomidine compared with values at 30 min infusion (p = 0.04, mean difference and 95% confidence interval of 221.6 and 2.2 to 441.0 pg·mL−1). In conclusion, three hours of sevoflurane anesthesia in pediatric patients < 3 years old did not provoke neuronal injury assessed by the plasma biomarker. Further studies regarding the effect of prolonged dexmedetomidine infusion on anesthetic neuronal injury are required.

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LSL 60101, a selective ligand for imidazoline I2 receptors, on glial fibrillary acidic protein concentration

European Journal of Pharmacology ◽

10.1016/0014-2999(95)00214-6 ◽

1995 ◽

Vol 280 (2) ◽

pp. 205-210 ◽

Cited By ~ 27

Author(s):

Regina Alemany ◽

Gabriel Olmos ◽

Pablo V. Escribá ◽

Angel Menargues ◽

Rossend Obach ◽

...

Keyword(s):

Glial Fibrillary Acidic Protein ◽

Protein Concentration ◽

Acidic Protein ◽

Selective Ligand

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Changes in the glial fibrillary acidic protein concentration in the medial part of vision tuber under the generation of conditioned reaction of active avoidance

Biopolymers and Cell ◽

10.7124/bc.0006dd ◽

2005 ◽

Vol 21 (1) ◽

pp. 60-63

Author(s):

A. L. Drozdov ◽

V. I. Chornaya

Keyword(s):

Glial Fibrillary Acidic Protein ◽

Active Avoidance ◽

Protein Concentration ◽

Acidic Protein ◽

Medial Part ◽

Conditioned Reaction

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Glial fibrillary acidic protein as a biomarker for brain injury in neonatal CHD

Cardiology in the Young ◽

10.1017/s1047951115002346 ◽

2016 ◽

Vol 26 (7) ◽

pp. 1282-1289 ◽

Cited By ~ 6

Author(s):

Stephanie L. McKenney ◽

Fahad F. Mansouri ◽

Allen D. Everett ◽

Ernest M. Graham ◽

Irina Burd ◽

...

Keyword(s):

Brain Injury ◽

Glial Fibrillary Acidic Protein ◽

Group Versus ◽

Acidic Protein ◽

Left Heart ◽

Perinatal Brain Injury ◽

Control Groups ◽

Protein Levels ◽

Brain Injured ◽

Student’S T

AbstractNeonates with critical CHD have evidence, by imaging, of preoperative brain injury, although the timing is unknown. We used circulating postnatal serum glial fibrillary acidic protein as a measure of acute perinatal brain injury in neonates with CHD. Glial fibrillary acidic protein was measured on admission and daily for the first 4 days of life in case and control groups; we included two control groups in this study – non-brain-injured newborns and brain-injured newborns. Comparisons were performed using the Kruskal–Wallis test with Dunn’s multiple comparisons, Student’s t-test, and χ2 test of independence where appropriate. In aggregate, there were no significant differences in overall glial fibrillary acidic protein levels between CHD patients (n=56) and negative controls (n=23) at any time point. By day 4 of life, 7/56 (12.5%) CHD versus 0/23 (0%) normal controls had detectable glial fibrillary acidic protein levels. Although not statistically significant, the 5/10 (50%) left heart obstruction group versus 1/17 (6%) conoventricular, 0/13 (0%) right heart, and 1/6 (17%) septal defect patients trended towards elevated levels of glial fibrillary acidic protein at day 4 of life. Overall, glial fibrillary acidic protein reflected no evidence for significant peripartum brain injury in neonates with CHD, but there was a trend for elevation by postnatal day 4 in neonates with left heart obstruction. This pilot study suggests that methods such as monitoring glial fibrillary acidic protein levels may provide new tools to optimise preoperative care and neuroprotection in high-risk neonates with specific types of CHD.

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Clinical research Clinical effects of sevoflurane anesthesia induction with a portable inhalational anesthetic circuit in pediatric patients

Archives of Medical Science ◽

10.5114/aoms.2015.50230 ◽

2015 ◽

Vol 4 ◽

pp. 796-800

Author(s):

Min Yu ◽

Chuanbao Han ◽

Qinhai Zhou ◽

Cunming Liu ◽

Zhengnian Ding

Keyword(s):

Clinical Research ◽

Pediatric Patients ◽

Anesthesia Induction ◽

Clinical Effects ◽

Sevoflurane Anesthesia ◽

Inhalational Anesthetic ◽

Anesthetic Circuit

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Dexmedetomidine for the prevention of emergence delirium and postoperative behavioral changes in pediatric patients with sevoflurane anesthesia: a double-blind, randomized trial

Drug Design Development and Therapy ◽

10.2147/dddt.s196075 ◽

2019 ◽

Vol Volume 13 ◽

pp. 897-905 ◽

Cited By ~ 12

Author(s):

Mengzhu Shi ◽

Shuai Miao ◽

Tianchu Gu ◽

Dongyue Wang ◽

Hui Zhang ◽

...

Keyword(s):

Randomized Trial ◽

Pediatric Patients ◽

Behavioral Changes ◽

Sevoflurane Anesthesia ◽

Double Blind ◽

Emergence Delirium

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Autoimmune Glial Fibrillary Acidic Protein Astrocytopathy in Children: A Retrospective Study

10.21203/rs.3.rs-839718/v1 ◽

2021 ◽

Author(s):

xiamei Zhuang ◽

Ke Jin ◽

Xiaoming Li ◽

Junwei Li

Keyword(s):

White Matter ◽

Glial Fibrillary Acidic Protein ◽

Pediatric Patients ◽

Lactic Dehydrogenase ◽

Subcortical White Matter ◽

Acidic Protein ◽

Cerebral White Matter ◽

Periventricular White Matter ◽

Cell Counts ◽

Adenosine Deaminase Activity

Abstract Objective: To describe the clinical features of autoimmune glial fibrillary acidic protein (GFAP) astrocytopathy in children.Method: Data from 11 pediatric patients with autoimmune GFAP astrocytopathywas retrospectively analyzed.Results: All of the patients showed encephalitis and meningoencephalitis or meningoencephalomyelitis with or without myelitis, include fever (45.4%), headaches (27.3%), dizziness (18.2%), drowsiness (18.2%) and mental disorders (18.2%). Cerebrospinal fluid (CSF) were detected in all patients. The white cell counts (WBC) (90.9%), lactic dehydrogenase levels (72.7%), protein level (36.4%), and adenosine deaminase activity (ADA) level (27.3%) were elevated, and the CSF glucose levels (72.7%) were slightly reduced. Nine patients (90%) were found to have brain abnormalities, of which five (50.0%) patients had abnormal symmetrical laminar patterns or line patterns hyperintensity lesions on T2-weighted and fluid-attenuated inversion recovery (FLAIR) images in the basal ganglia, hypothalamus, subcortical white matter and periventricular white matter. The linear radial enhancement pattern of the cerebral white matter was only seen in two patients, the most common being abnormal enhancement of leptomeninges (50%). Five patients had longitudinally extensive spinal cord lesions.Conclusion: The findings of pediatric patients with autoimmune GFAP astrocytopathy is different from the previous reports.

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Glial Fibrillary Acidic Protein Astrocytopathy in Pediatric Patients: A Retrospective Study

Frontiers in Pediatrics ◽

10.3389/fped.2020.626564 ◽

2021 ◽

Vol 8 ◽

Author(s):

Haixia Huang ◽

Ke Bai ◽

Yueqiang Fu ◽

Siwei Lu ◽

Yunni Ran ◽

...

Keyword(s):

Spinal Cord ◽

Glial Fibrillary Acidic Protein ◽

Pediatric Patients ◽

Clinical Symptoms ◽

Acidic Protein ◽

Gadolinium Enhancement ◽

Urine Retention ◽

Limb Weakness ◽

Disturbance Of Consciousness ◽

Intravenous Steroids

Autoimmune glial fibrillary acidic protein astrocytopathy is a novel form of autoimmune meningoencephalitis related to GFAP autoantibodies. This condition is still being characterized, and few pediatric patients have been identified. Here, we report three patients presenting with fever, nausea, and headache, following progressive disturbance of consciousness, limb weakness, dyspnea, or urine retention. MRI analysis revealed that T2-hyperintense lesions, or enhancement of the meninges and spinal cord. CSF and serum analyses revealed they were positive for GFAP antibody, confirming GFAP astrocytopathy diagnosis. Treating the patients with IVIG, with or without intravenous steroids, gradually improved their clinical symptoms. Our findings indicate that GFAP astrocytopathy should be considered in children who are clinically diagnosed with meningoencephalitis, whether or not myelitis is present, and if the MRI reveals enhancement of meninges or spinal cord, T2-hyperintense lesions, or a pattern of linear perivascular gadolinium enhancement. Suspected cases should be tested for GFAP antibody as soon as possible because these patients may benefit from immunotherapy.

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