The appearance of S-100 protein in serum during and immediately after cardiopulmonary bypass surgery: a possible marker for cerebral injury.
OBJECTIVE
To investigate the appearance and elimination of brain-specific S-100 protein in serum during and immediately after cardiopulmonary bypass.


METHODS
Prospective study.


METHODS
Twenty-nine patients undergoing elective cardiac surgery.


METHODS
Twenty-seven patients were operated on for coronary artery disease; two patients had valve replacement. Serial measurements of S-100 in arterial blood during and up to 48 hours after cardiopulmonary bypass were made.


RESULTS
The perioperative and postoperative course was uneventful in 25 patients, with no clinical signs of neurologic complications. S-100 was not detected before extracorporeal circulation was started. Detectable concentrations (detection limit, 0.2 microgram/L) appeared in serum after 10 minutes of perfusion and reached maximum levels, 2.43 +/- 0.3 micrograms/L, at the end of bypass. The levels then declined with elimination t1/2 of 2.2 hours. Only two patients had detectable concentrations of S-100 48 hours after the end of bypass. In four patients who developed clinical signs of cerebral injury, levels of S-100 were significantly higher at the end of bypass and 24 hours after the end of bypass.


CONCLUSIONS
Cardiopulmonary bypass initiates a release of brain-specific S-100 to the systemic circulation. The release and elimination of S-100 seem to follow a reproducible pattern in patients with no signs of cerebral injury. In patients who developed cerebral injury, the concentrations of S-100 in blood were increased, thus suggesting that S-100 may be a usable marker for cerebral injury after extracorporeal circulation.
Blomquist
S
S
Department of Anesthesiology, University Hospital, Malmö-Lund, Sweden.
Johnsson
P
P
Lührs
C
C
Malmkvist
G
G
Solem
J O
JO
Alling
C
C
Ståhl
E
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D001927:Brain Diseases / Q000175:diagnosis*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis*; D011446:Prospective Studies; D009418:S100 Proteins / Q000097:blood*
D015415:Biomarkers; D009418:S100 Proteins