Is there a relationship between serum S-100beta protein and neuropsychologic dysfunction after cardiopulmonary bypass?
OBJECTIVE
Over the past decade, the glial protein S-100beta has been used to detect cerebral injury in a number of clinical settings including cardiac surgery. Previous investigations suggest that S-100beta is capable of identifying patients with cerebral dysfunction after cardiopulmonary bypass. Whether detection of elevated levels S-100beta reflects long-term cognitive impairment remains to be shown. The present study evaluated whether perioperative release of S-100beta after coronary artery operations with cardiopulmonary bypass could predict early or late neuropsychologic impairment.


METHODS
A total of 100 patients undergoing elective coronary bypass without a previous history of neurologic events were prospectively studied. To exclude noncerebral sources of S-100beta, we did not use cardiotomy suction or retransfusion of shed mediastinal blood. Serial perioperative measurements of S-100beta were performed with the use of a new sensitive immunoluminometric assay up to 8 hours after the operation. Patients underwent cognitive testing on a battery of 11 tests before the operation, before discharge from the hospital, and 3 months later.


RESULTS
No significant correlation was found between S-100beta release and neuropsychologic measures either 5 days or 3 months after the operation.


CONCLUSIONS
Despite using a sensitive immunoluminometric assay of S-100beta, we found no evidence to support the suggestion that early release of S-100beta may reflect long-term neurologic injury capable of producing cognitive impairment.
Westaby
S
S
Oxford Heart Centre, John Radcliffe Hospital, Oxford, United Kingdom.
Saatvedt
K
K
White
S
S
Katsumata
T
T
van Oeveren
W
W
Bhatnagar
N K
NK
Brown
S
S
Halligan
P W
PW
D000768:Anesthesia, General; D001007:Anxiety / Q000175:diagnosis / Q000209:etiology; D015415:Biomarkers / Q000097:blood; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D003072:Cognition Disorders / Q000097:blood / Q000175:diagnosis* / Q000209:etiology*; D003866:Depressive Disorder / Q000175:diagnosis / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000175:diagnosis / Q000209:etiology; D008875:Middle Aged; D009483:Neuropsychological Tests; D011446:Prospective Studies; D009418:S100 Proteins / Q000097:blood*; D018709:Statistics, Nonparametric
D015415:Biomarkers; D009418:S100 Proteins