S100beta correlates with neurologic complications after aortic operation using circulatory arrest.
BACKGROUND
Astrocyte protein S100beta is a potential serum marker for neurologic injury. The goals of this study were to determine whether elevated serum S100beta correlates with neurologic complications in patients requiring hypothermic circulatory arrest (HCA) during thoracic aortic repair, and to determine the impact of retrograde cerebral perfusion (RCP) on S100beta release in this setting.


METHODS
Thirty-nine consecutive patients underwent thoracic aortic repairs during HCA; RCP was used in 25 patients. Serum S100beta was measured preoperatively, after cardiopulmonary bypass, and 24 hours postoperatively.


RESULTS
Neurologic complications occurred in 3 patients (8%). These patients had higher postbypass S100beta levels (7.17 +/- 1.01 microg/L) than those without neurologic complications (3.63 +/- 2.31 microg/L, p = 0.013). Patients with S100beta levels of 6.0 microg/L or more had a higher incidence of neurologic complications (3 of 7, 43%) compared with those who had levels less than 6.0 microg/L (0 of 30, p = 0.005). Retrograde cerebral perfusion did not affect S100beta release.


CONCLUSIONS
Serum S100beta levels of 6.0 microg/L or higher after HCA correlates with postoperative neurologic complications. Using serum S100beta as a marker for brain injury, RCP does not provide improved cerebral protection over HCA alone.
LeMaire
S A
SA
Michael E. DeBakey Department of Surgery, Baylor College of Medicine, The Methodist Hospital, Houston, Texas, USA.
Bhama
J K
JK
Schmittling
Z C
ZC
Oberwalder
P J
PJ
Köksoy
C
C
Raskin
S A
SA
Curling
P E
PE
Coselli
J S
JS
D000368:Aged; D001013:Aorta, Thoracic / Q000601:surgery*; D001921:Brain / Q000098:blood supply; D001925:Brain Damage, Chronic / Q000097:blood / Q000175:diagnosis*; D002315:Cardiopulmonary Bypass; D005260:Female; D006324:Heart Arrest, Induced; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000097:blood / Q000175:diagnosis*; D011237:Predictive Value of Tests; D012039:Regional Blood Flow / Q000502:physiology; D009418:S100 Proteins / Q000097:blood*
D009418:S100 Proteins; C110294:S100A1 protein