title: Serum S100 protein: a potential marker for cerebral events during cardiopulmonary bypass.
abstract: 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.affiliation: Oxford Heart Centre, England.
authors.forename: S
authors.initials: S
authors.lastname: Westaby
authors.forename: P
authors.initials: P
authors.lastname: Johnsson
authors.forename: A J
authors.initials: AJ
authors.lastname: Parry
authors.forename: S
authors.initials: S
authors.lastname: Blomqvist
authors.forename: J O
authors.initials: JO
authors.lastname: Solem
authors.forename: C
authors.initials: C
authors.lastname: Alling
authors.forename: R
authors.initials: R
authors.lastname: Pillai
authors.forename: D P
authors.initials: DP
authors.lastname: Taggart
authors.forename: C
authors.initials: C
authors.lastname: Grebenik
authors.forename: E
authors.initials: E
authors.lastname: Ståhl
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D002561:Cerebrovascular Disorders / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D009418:S100 Proteins / Q000097:blood*; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D009418:S100 Proteins