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Serum Protein Biomarkers in the Management of Severe Traumatic Brain Injury

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Management of Severe Traumatic Brain Injury

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Abstract

The management of severe traumatic brain injury (TBI) is complex and difficult as patients present with a vast heterogeneity of injuries and may deteriorate due to secondary injuries despite treatment. Cerebrally enriched proteins of brain tissue fate in serum have been introduced as biomarkers attempting to better evaluate damage extent and trajectories. In this narrative chapter, we review the most commonly studied protein biomarkers, S100B, neuron-specific enolase (NSE), glial fibrillary acidic protein (GFAP), ubiquitin carboxy-terminal hydrolase L1 (UCH-L1), and neurofilament light (NF-L), and how they predict injury severity and functional outcome, monitor deterioration, and may be used to determine treatment efficacy in trials. Further, we highlight opportunities and pitfalls in combinations of biomarkers, extracranial trauma, pediatric use, and available assays with the focus on creating a working manual for implementing protein biomarkers in clinical use of severe TBI.

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Authors and Affiliations

  1. Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden

    Eric Peter Thelin

  2. Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK

    Eric Peter Thelin

  3. Department of Physiology and Pharmacology, Section of Perioperative Medicine and Intensive Care, Karolinska Institutet, Stockholm, Sweden

    David W. Nelson

  4. Department of Anaesthesia and Intensive Care, Hallands Hospital, Halmstad, Sweden

    Johan Undén

  5. Department of Operation and Intensive Care, Hallands Hospital, Halmstad, Sweden

    Johan Undén

  6. Lund University, Lund, Sweden

    Johan Undén

  7. Department of Neurosurgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark

    Ramona Åstrand

  8. Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden

    Bo-Michael Bellander

  9. Department of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden

    Bo-Michael Bellander

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  1. Eric Peter Thelin
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  2. David W. Nelson
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  3. Johan Undén
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  4. Ramona Åstrand
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  5. Bo-Michael Bellander
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Correspondence to Eric Peter Thelin .

Editor information

Editors and Affiliations

  1. Department of Neurosurgery, Haukeland University Hospital, Bergen, Norway

    Terje Sundstrøm

  2. Department of Anaesthesia and Intensive Care, Lund University Hospital, Lund, Sweden

    Per-Olof Grände

  3. Department of Neurosurgery, Tampere University Hospital, Tampere, Finland

    Teemu Luoto

  4. Department of Neurosurgery, Odense University Hospital, Odense, Denmark

    Christina Rosenlund

  5. Department of Operation and Intensive Care, Halmstad Hospital, Halmstad, Sweden

    Johan Undén

  6. Department of Clinical Medicine K1, University of Bergen, Bergen, Norway

    Knut Gustav Wester

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Thelin, E.P., Nelson, D.W., Undén, J., Åstrand, R., Bellander, BM. (2020). Serum Protein Biomarkers in the Management of Severe Traumatic Brain Injury. In: Sundstrøm, T., Grände, PO., Luoto, T., Rosenlund, C., Undén, J., Wester, K. (eds) Management of Severe Traumatic Brain Injury. Springer, Cham. https://doi.org/10.1007/978-3-030-39383-0_50

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