Related Experiment Video
Updated: Jul 5, 2026
Systems Analysis of the Neuroinflammatory and Hemodynamic Response to Traumatic Brain Injury
Published on: May 27, 2022
Neurological injury markers in children with septic shock
Angela A Hsu1, Kimberly Fenton, Steven Weinstein
1Division of Critical Care Medicine, Children's Research Institute, Children's National Medical Center, Washington, DC, USA. ahsu@cnmc.org
Insights
Children with septic shock show elevated serum markers for neurologic injury, including S100beta and neuron-specific enolase (NSE). These findings suggest subclinical brain injuries in pediatric septic shock patients.
Area of Science:
- Pediatric critical care medicine
- Neurology
- Biomarker research
Background:
- Septic shock in children can lead to neurological complications.
- Known serum markers of neurologic injury exist but their role in pediatric septic shock is unclear.
Purpose of the Study:
- To investigate elevated serum markers of neurologic injury in children diagnosed with septic shock.
- To compare these markers against a control group of febrile children.
Main Methods:
- Prospective observational study in a pediatric intensive care unit.
- Enrolled 24 children with septic shock and 32 febrile controls.
- Measured serum biomarkers (S100beta, NSE, GFAP) and performed continuous electroencephalography (cEEG).
Main Results:
- Children with septic shock had significantly higher serum S100beta and NSE levels compared to controls.
- Serum GFAP was detected in some septic children but not controls.
- All children with septic shock exhibited moderate to severe encephalopathy on cEEG.
Conclusions:
- Elevated neurologic injury markers in children with septic shock indicate potential subclinical brain injuries.
- Further research is needed to correlate these markers with long-term neurologic outcomes.
- Identifying at-risk children for neurologic injury from septic shock is crucial.
Objective:
To determine whether known serum markers of neurologic injury are increased in children with septic shock.
Design:
Prospective, observational study.
Setting:
Tertiary-care, pediatric intensive care unit.
Patients:
Two cohorts of children (n = 24) with septic shock were prospectively enrolled within 24 hrs of their diagnosis. In cohort 1, serum markers (S100beta, neuron-specific enolase [NSE], and glial fibrillary acidic protein [GFAP]) were determined (n = 18). In cohort 2, in addition to serum markers, urine S100beta and GFAP were determined, and continuous electroencephalography (cEEG) was performed. Children who presented to the emergency room with a fever served as controls (n = 32). Children with known neurologic conditions were excluded.
Interventions:
None.
Measurements And Main Results:
Serum and urine were collected daily for up to 7 days or until pediatric intensive care unit discharge. Biomarker concentrations were determined by commercially available enzyme-linked immunosorbent assays. cEEG was performed on days 1, 2, 4, and 7 in a 16-channel montage for at least 6 hrs. Physical examinations did not reveal focal neurologic deficits. Children with septic shock demonstrated increased serum S100beta and NSE compared with controls (mean +/- SEM: 10.5 microg/L +/- 2.4 vs. .9 microg/L +/- .1, p < .001; 96.6 microg/L +/- 8.9 vs. 4.0 microg/L +/- 1.3, p < .001, respectively). Serum GFAP was detectable in five septic children and none of the controls. In cohort 2, urine of four patients demonstrated measurable S100beta levels, and GFAP was detected in one child (nonsurvivor). cEEG demonstrated moderate to severe encephalopathy in all children studied.
Conclusions:
Markers of neurologic injuries are increased in children with septic shock. This may indicate subclinical injuries that are either transient or permanent. Studies that correlate the long-term neurologic outcome of children with these markers are needed to identify children at risk for neurologic injuries from septic shock.
Related Concept Videos
01:25Secondary Spinal Cord Injury llI: Pathophysiology
01:20Blood Studies for Cardiovascular System I: Cardiac Biomarkers
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...