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S100B blood levels correlate with rewarming time and cerebral Doppler in pediatric open heart surgery.

Abstract

BACKGROUND

Brain 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.

METHODS

Thirty-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.

RESULTS

Both 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).

CONCLUSIONS

The 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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  • Authors+Show Affiliations

    ,

    Department of Pediatrics, Giannina Gaslini Children's University Hospital, 1-16147 Genoa, Italy. dgazzolo@hotmail.com

    , , , , ,

    Source

    MeSH

    Blood Volume
    Cardiac Surgical Procedures
    Cardiopulmonary Bypass
    Follow-Up Studies
    Heart Arrest, Induced
    Heart Defects, Congenital
    Humans
    Hypothermia, Induced
    Infant
    Infant Welfare
    Infant, Newborn
    Middle Cerebral Artery
    Multivariate Analysis
    Nerve Growth Factors
    Rewarming
    S100 Calcium Binding Protein beta Subunit
    S100 Proteins
    Statistics as Topic
    Time Factors
    Treatment Outcome
    Ultrasonography, Doppler, Transcranial

    Pub Type(s)

    Comparative Study
    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    12546072

    Citation

    TY - JOUR T1 - S100B blood levels correlate with rewarming time and cerebral Doppler in pediatric open heart surgery. AU - Gazzolo,Diego, AU - Masetti,Paolo, AU - Vinesi,Paola, AU - Meli,Marco, AU - Abella,Raul, AU - Marcelletti,Carlo, AU - Michetti,Fabrizio, PY - 2003/1/28/pubmed PY - 2003/5/3/medline PY - 2003/1/28/entrez SP - 279 EP - 84 JF - Journal of cardiac surgery JO - J Card Surg VL - 17 IS - 4 N2 - BACKGROUND: Brain 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. METHODS: Thirty-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. RESULTS: Both 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). CONCLUSIONS: The 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. SN - 0886-0440 UR - https://www.unboundmedicine.com/medline/citation/12546072/S100B_blood_levels_correlate_with_rewarming_time_and_cerebral_Doppler_in_pediatric_open_heart_surgery_ L2 - http://onlinelibrary.wiley.com/resolve/openurl?genre=article&amp;sid=nlm:pubmed&amp;issn=0886-0440&amp;date=2002&amp;volume=17&amp;issue=4&amp;spage=279 ER -