Blood S-100 protein concentration in children undergoing cardiac surgery.
OBJECTIVE
To investigate plasma levels of the betabeta isomer of S-100 protein and to assess the relationship between post-cardiopulmonary bypass (CPB) levels of this marker and a variety of perioperative and patient factors in children undergoing cardiac surgery.


METHODS
Prospective study.


METHODS
University hospital.


METHODS
Twenty-five children.


METHODS
Blood samples (2 mL) for S-100 determinations were collected after the induction of anesthesia, 30 minutes after aortic cross-clamping, 1 hour after the termination of CPB, and 5 and 24 hours after the operation. Electroencephalogram activity was recorded, and neurologic examination was performed on all children 1 day before and 10 days after the operation. Lowest values of nasopharyngeal temperature, mean arterial pressure, arterial carbon dioxide tension (PaCO2), pH, and hematocrit during CPB were recorded.


RESULTS
The overall change in S-100 during the study period was found to be statistically significant (p < 0.0001). Correlation between deltaS-100 and age (r = -0.45; p = 0.04), body surface area (r = -0.63; p = 0.002), nasopharyngeal temperature (r = -0.55; p = 0.01), and PaCO2 (r = -0.55; p = 0.009) was statistically significant in infants and children. Multivariate regression analysis indicated significant effects of PaCO2 and body surface area on deltaS-100 levels and area under the curve values.


CONCLUSIONS
In contrast to newborns, infants and older children showed prominent increases in S-100 protein concentration. Lack of pathologic electroencephalogram findings and neurologic signs in the postoperative period precludes the clinical use of S-100 protein concentration as a sensitive marker of cerebral injury.
Department of Anesthesiology and Cardiovascular Surgery, Istanbul Medical Faculty, Istanbul University, Turkey.
E
E
Camci
M
M
Tuğrul
K
K
Korkut
E
E
Tireli
D000758:Anesthesia; D019540:Area Under Curve; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D002648:Child; D002675:Child, Preschool; D004562:Electrocardiography; D004569:Electroencephalography; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012044:Regression Analysis; D009418:S100 Proteins / Q000097:blood*
D009418:S100 Proteins