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S100B blood levels correlate with rewarming time and cerebral Doppler in pediatric open heart surgery.
BACKGROUNDBrain hyperthermia, accompanying the rewarming phase of cardiopulmonary bypass (CPB), has been involved in the genesis of postoperative brain damage. Blood S100B levels are emerging as a marker of brain distress, and could offer a reliable monitoring tool at different times during and after open heart surgery.
METHODSThirty-two patients undergoing repair of congenital heart disease with CPB and deep hypothermic circulatory arrest (DHCA) were monitored by S100B blood levels and middle cerebral artery Doppler velocimetry pulsatility index (MCA PI) before, during, and after surgical procedure at five predetermined time-points.
RESULTSBoth S100B and MCA PI significantly increased, MCA PI values exhibiting a peak at the end of surgery time-point (p > 0.05), while S100B blood levels were increased at the end of CPB (p < 0.05). Multivariate analysis, with S100B levels measured at the end of CPB as dependent variable, showed a positive significant correlation with MCA PI (p = 0.04), with the CPB and the rewarming duration (p = 0.03 and p = 0.009, respectively).
CONCLUSIONSThe present results show a significant correlation between a biochemical marker of brain damage and an index of increased cerebrovascular resistance, with higher levels during the rewarming CPB phase in pediatric open heart surgery.
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Journal of cardiac surgery 17:4 pg 279-84
Cardiac Surgical Procedures
Heart Arrest, Induced
Heart Defects, Congenital
Middle Cerebral Artery
Nerve Growth Factors
S100 Calcium Binding Protein beta Subunit
Statistics as Topic
Ultrasonography, Doppler, Transcranial
Pub Type(s)Comparative Study
Research Support, Non-U.S. Gov't