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Microemboli from cardiopulmonary bypass are associated with a serum marker of brain injury.

Abstract

An increasing number of reports surrounding neurologic injury in the setting of cardiac surgery has focused on utilizing biomarkers as intermediate outcomes. Previous research has associated cerebral microemboli and neurobehavioral deficits with biomarkers. A leading source of cerebral microemboli is the cardiopulmonary bypass (CPB) circuit. This present study seeks to identify a relationship between microemboli leaving the CPB circuit and a biomarker of neurologic injury. We enrolled 71 patients undergoing coronary artery bypass grafting at a single institution from October 14, 2004 through December 5, 2007. Microemboli were monitored using Power-M-Mode Doppler in the inflow and outflow of the CPB circuit. Blood was sampled before and within 48 hours after surgery. Neurologic injury was measured using S100beta (microg/L). Significant differences in post-operative S100beta relative to microemboli leaving the circuit were tested with analysis of variance and Kruskal-Wallis. Most patients had increased serum levels of S100beta (mean .25 microg/L, median .15 microg/L) following surgery. Terciles of microemboli measured in the outflow (indexed to the duration of time spent on CPB) were associated with elevated levels of S100beta (p = .03). Microemboli leaving the CPB circuit were associated with increases in postoperative S100beta levels. Efforts aimed at reducing microembolic load leaving the CPB circuit should be adopted to reduce brain injury.

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    MeSH

    Aged
    Biological Markers
    Brain Injuries
    Cardiopulmonary Bypass
    Female
    Humans
    Intracranial Embolism
    Male
    Nerve Growth Factors
    Reproducibility of Results
    S100 Calcium Binding Protein beta Subunit
    S100 Proteins
    Sensitivity and Specificity

    Pub Type(s)

    Clinical Trial
    Journal Article
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    20437790

    Citation

    TY - JOUR T1 - Microemboli from cardiopulmonary bypass are associated with a serum marker of brain injury. AU - Groom,Robert C, AU - Quinn,Reed D, AU - Lennon,Paul, AU - Welch,Janine, AU - Kramer,Robert S, AU - Ross,Cathy S, AU - Beaulieu,Peter A, AU - Brown,Jeremiah R, AU - Malenka,David J, AU - O'Connor,Gerald T, AU - Likosky,Donald S, AU - ,, PY - 2010/5/5/entrez PY - 2010/5/5/pubmed PY - 2010/6/9/medline SP - 40 EP - 4 JF - The Journal of extra-corporeal technology JO - J Extra Corpor Technol VL - 42 IS - 1 N2 - An increasing number of reports surrounding neurologic injury in the setting of cardiac surgery has focused on utilizing biomarkers as intermediate outcomes. Previous research has associated cerebral microemboli and neurobehavioral deficits with biomarkers. A leading source of cerebral microemboli is the cardiopulmonary bypass (CPB) circuit. This present study seeks to identify a relationship between microemboli leaving the CPB circuit and a biomarker of neurologic injury. We enrolled 71 patients undergoing coronary artery bypass grafting at a single institution from October 14, 2004 through December 5, 2007. Microemboli were monitored using Power-M-Mode Doppler in the inflow and outflow of the CPB circuit. Blood was sampled before and within 48 hours after surgery. Neurologic injury was measured using S100beta (microg/L). Significant differences in post-operative S100beta relative to microemboli leaving the circuit were tested with analysis of variance and Kruskal-Wallis. Most patients had increased serum levels of S100beta (mean .25 microg/L, median .15 microg/L) following surgery. Terciles of microemboli measured in the outflow (indexed to the duration of time spent on CPB) were associated with elevated levels of S100beta (p = .03). Microemboli leaving the CPB circuit were associated with increases in postoperative S100beta levels. Efforts aimed at reducing microembolic load leaving the CPB circuit should be adopted to reduce brain injury. SN - 0022-1058 UR - https://www.unboundmedicine.com/medline/citation/20437790/Microemboli_from_cardiopulmonary_bypass_are_associated_with_a_serum_marker_of_brain_injury_ L2 - http://www.scholaruniverse.com/ncbi-linkout?id=20437790 ER -