BACKGROUND: There is no simple method to determine the incidence or severity of brain injury after a cardiac operation. A serum marker equivalent to cardiac enzymes is required. S100 protein leaks from the cerebrospinal fluid to blood after cerebral injury. We sought to determine the pattern of release after extracorporeal circulation (ECC). METHODS: Thirty-four patients without neurologic problems underwent coronary bypass using ECC. Four had carotid stenoses. Nine others underwent coronary bypass without ECC. Serum S100 levels were measured before, during, and after the operation. RESULTS: S100 was not detected before sternotomy. Postoperative levels of S100 were related to duration of perfusion (r = 0.89, p < 0.001). Patients who did not have ECC had undetectable or fractionally raised levels except in 1 who suffered a stroke. No patient in whom ECC was used suffered an event, but those with carotid stenosis had greater S100 levels. CONCLUSIONS: S100 protein leaks into blood during ECC and may reflect both cerebral injury and increased permeability of the blood brain barrier. S100 is a promising marker for cerebral injury in cardiac surgery if elevated levels can be linked with clinical outcome.
BACKGROUND: There is no simple method to determine the incidence or severity of brain injury after a cardiac operation. A serum marker equivalent to cardiac enzymes is required. S100 protein leaks from the cerebrospinal fluid to blood after cerebral injury. We sought to determine the pattern of release after extracorporeal circulation (ECC). METHODS: Thirty-four patients without neurologic problems underwent coronary bypass using ECC. Four had carotid stenoses. Nine others underwent coronary bypass without ECC. Serum S100 levels were measured before, during, and after the operation. RESULTS:S100 was not detected before sternotomy. Postoperative levels of S100 were related to duration of perfusion (r = 0.89, p < 0.001). Patients who did not have ECC had undetectable or fractionally raised levels except in 1 who suffered a stroke. No patient in whom ECC was used suffered an event, but those with carotid stenosis had greater S100 levels. CONCLUSIONS:S100 protein leaks into blood during ECC and may reflect both cerebral injury and increased permeability of the blood brain barrier. S100 is a promising marker for cerebral injury in cardiac surgery if elevated levels can be linked with clinical outcome.
Authors: Toru Okamura; Nobuyuki Ishibashi; T Susheel Kumar; David Zurakowski; Yusuke Iwata; Hart G W Lidov; Richard A Jonas Journal: Ann Thorac Surg Date: 2010-12 Impact factor: 4.330
Authors: Andrew Laflam; Brijen Joshi; Kenneth Brady; Gayane Yenokyan; Charles Brown; Allen Everett; Ola Selnes; Edward McFarland; Charles W Hogue Journal: Anesth Analg Date: 2015-01 Impact factor: 5.108
Authors: Daniel H Sahlein; Eric J Heyer; Anita Rampersad; Christopher J Winfree; Robert A Solomon; Alan I Benvenisty; Donald O Quest; Evelyn Du; E Sander Connolly Journal: Neurosurgery Date: 2003-12 Impact factor: 4.654