Normal serum concentrations of S-100 protein and changes in cerebrospinal fluid concentrations of S-100 protein during and after thoracoabdominal aortic aneurysm surgery: Is S-100 protein a biochemical marker of clinical value in detecting spinal cord ischemia?
OBJECTIVE
This study was performed to determine the concentration of S-100 protein in serum and in the cerebrospinal fluid (CSF) during and 24 hours after thoracoabdominal aortic aneurysm repair.


METHODS
This prospective study was performed at St. Antonius Hospital in Nieuwegein, The Netherlands. Eight patients who underwent elective thoracoabdominal aortic surgery participated in the study. Arterial blood and CSF samples for analysis of S-100 protein were drawn after induction of anesthesia, during the cross-clamp period of the critical segment, after 5 minutes of reperfusion, during the closure of the skin, and 24 hours after closure of the skin.


RESULTS
No increase in S-100 protein concentration could be detected in serum (< 0.2 microg/L). The S-100 protein concentration in CSF increased during the procedure in all patients (4.2 +/- 3.1 microg/L). However, in one patient, who became paraplegic, the S-100 protein concentration in CSF increased even further after 24 hours (10 microg/L).


CONCLUSIONS
The preliminary results suggest that S-100 protein in CSF may be a marker of clinical value in evaluating the effects of measures to detect and reduce spinal cord ischemia.
van Dongen
E P
EP
Department of Anesthesiology and Intensive Care, St. Antonius Hospital, Nieuwegein, The Netherlands.
Ter Beek
H T
HT
Boezeman
E H
EH
Schepens
M A
MA
Langemeijer
H J
HJ
Aarts
L P
LP
D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D015415:Biomarkers / Q000032:analysis; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000175:diagnosis; D007511:Ischemia / Q000175:diagnosis* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis; D011446:Prospective Studies; D009418:S100 Proteins / Q000134:cerebrospinal fluid / Q000378:metabolism*; D013116:Spinal Cord / Q000098:blood supply*
D015415:Biomarkers; D009418:S100 Proteins