BACKGROUND: Cerebral injury after Cardiopulmonary bypass (CPB) is still a serious and unpredictable complication. The S-100beta serum marker has been suggested as potentially useful in the detection of cerebral injury during and after CPB. Direct comparisons of whether laminar or pulsatile pump flow in CABG leads to higher S-100beta values and which type might be more neuroprotective have not been made so far. METHODS:All 21 patients of the study were undergoingCABG for the first time and had no history of cerebral disease in whatever form. They were divided into two groups: laminar (n = 10) versus pulsatile (n = 11) pump flow. In all cases, a Stöckert roller pump (Fa. Stöckert, Munich, Germany) with a laminar and pulsatile running mode was used for cardiopulmonary bypass. Serum S-100beta levels were detected using a monoclonal immunoradiometric assay (Sangtec Medical AB, Bromma, Sweden). In total, 5 different samples were drawn per patient, starting before intubation and ending 36 hours after surgery. RESULTS:S-100beta peak values were found at skin closure. Median levels were lower in the pulsatile group. Due to the small study group and wide range, results are non-significant. CONCLUSION: The results indicate that pulsatile flow might have a more neuroprotective effect than laminar flow as S-100beta values were lower.
RCT Entities:
BACKGROUND:Cerebral injury after Cardiopulmonary bypass (CPB) is still a serious and unpredictable complication. The S-100beta serum marker has been suggested as potentially useful in the detection of cerebral injury during and after CPB. Direct comparisons of whether laminar or pulsatile pump flow in CABG leads to higher S-100beta values and which type might be more neuroprotective have not been made so far. METHODS: All 21 patients of the study were undergoing CABG for the first time and had no history of cerebral disease in whatever form. They were divided into two groups: laminar (n = 10) versus pulsatile (n = 11) pump flow. In all cases, a Stöckert roller pump (Fa. Stöckert, Munich, Germany) with a laminar and pulsatile running mode was used for cardiopulmonary bypass. Serum S-100beta levels were detected using a monoclonal immunoradiometric assay (Sangtec Medical AB, Bromma, Sweden). In total, 5 different samples were drawn per patient, starting before intubation and ending 36 hours after surgery. RESULTS:S-100beta peak values were found at skin closure. Median levels were lower in the pulsatile group. Due to the small study group and wide range, results are non-significant. CONCLUSION: The results indicate that pulsatile flow might have a more neuroprotective effect than laminar flow as S-100beta values were lower.