The effect of cardiotomy suction on the brain injury marker S100beta after cardiopulmonary bypass.
BACKGROUND
An increase of S100beta in serum during cardiopulmonary bypass (CPB) has been interpreted as a sign of brain injury. Cardiotomy suction may cause fat embolization, and its role in the S100beta increase was examined.


METHODS
Twenty coronary artery operation patients were randomly assigned to two groups, 10 with suction during CPB to cardiotomy reservoir (CR), 10 to cell saving device (CS). S100beta was measured (immunoassay) in blood from the patients and from cell saving device after processing. In 7 additional patients S100beta was measured in the cell saving device before processing and directly from the wound at sternotomy.


RESULTS
Before anesthesia, serum S100beta was 0.03+/-0.06 microg/L. At the end of CPB it was 2.47+/-1.31 microg/L and 0.44+/-0.27 microg/L (CR vs CS; p < 0.001). S100beta was 33+/-12 microg/L in CS reservoir and 42+/-18 microg/L in blood from the wound.


CONCLUSIONS
Most serum S100beta after CPB with cardiotomy suction may be of extracerebral origin. S100beta after CPB with cell saving device was the same as after off-pump operation. The interpretation that an increase in S100beta during CPB in patients reflects cerebral injury must be questioned.
Anderson
R E
RE
Department of Cardiothoracic Anaesthetics and Intensive Care, Karolinska Hospital, Stockholm, Sweden. russell.anderson@kirurgi.ki.se
Hansson
L O
LO
Liska
J
J
Settergren
G
G
Vaage
J
J
D000368:Aged; D002135:Calcium-Binding Proteins / Q000097:blood*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects* / Q000379:methods*; D002561:Cerebrovascular Disorders / Q000097:blood* / Q000209:etiology; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D006801:Humans; D008875:Middle Aged; D009414:Nerve Growth Factors; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins / Q000097:blood*; D013396:Suction
D002135:Calcium-Binding Proteins; D009414:Nerve Growth Factors; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins