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Brain Biomarkers in Pediatric Cardiac Disease: A Scoping Review of the Literature from 1998 to 2026

Ryan Luke Sodemann1, Amanda Mosher2, Emma Hartman2

  • 1Department of Emergency Medicine, Harvard Medical School, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA. Luke.Sodemann@childrens.harvard.edu.

Pediatric Cardiology
|June 26, 2026
PubMed

Insights

Blood brain biomarkers (BBM) show promise for predicting neurologic outcomes in pediatric patients with congenital heart disease (CHD) or after cardiac arrest (CA). Further research is needed due to limited studies correlating BBM with poor neurologic outcomes.

Area of Science:

  • Neurology
  • Pediatric Cardiology
  • Biomarkers

Background:

  • Pediatric congenital heart disease (CHD) and cardiac arrest (CA) can lead to significant brain injury.
  • Accurate prediction of neurologic outcomes is crucial for managing these vulnerable patients.
  • Blood brain biomarkers (BBM) are increasingly investigated for their potential in assessing brain injury.

Purpose of the Study:

  • To conduct a scoping review characterizing the relationship between blood brain biomarkers (BBM) and neurologic outcomes in pediatric patients with CHD and/or following CA.
  • To identify commonly studied BBM and their correlation with neurologic outcomes in this population.

Main Methods:

  • A comprehensive literature search was conducted across PubMed, Embase, Cochrane Library, and Web of Science.
  • Inclusion criteria focused on human pediatric subjects (≤18 years) with CHD and/or CA, and studies measuring BBM, excluding adult populations and inflammatory/imaging biomarkers.
  • Data extraction and synthesis followed PRISMA-ScR guidelines, with a minimum of two reviewers screening 3687 articles, ultimately including 87 studies.

Main Results:

  • The review included 87 studies, with S100B, GFAP, and NSE being the most frequently analyzed BBM.
  • Over half of the studies incorporated neurologic imaging/monitoring, and nearly half utilized neurodevelopmental/neurofunctional testing.
  • A significant correlation (67.4%) was observed between BBM and poor neurologic outcomes when neurodevelopmental/functional testing was reported.

Conclusions:

  • Blood brain biomarkers demonstrate potential in predicting neurologic outcomes for pediatric patients experiencing cardiac arrest or undergoing interventions for congenital heart disease.
  • The current body of research, while promising, is limited, underscoring the need for further investigation to validate BBM utility in this pediatric population.

Keywords:
BiomarkerBrain injuriesCardiac arrestCongenital heart diseasePediatric

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