S100B blood levels correlate with rewarming time and cerebral Doppler in pediatric open heart surgery.
BACKGROUND
Brain hyperthermia, accompanying the rewarming phase of cardiopulmonary bypass (CPB), has been involved in the genesis of postoperative brain damage. Blood S100B levels are emerging as a marker of brain distress, and could offer a reliable monitoring tool at different times during and after open heart surgery.


METHODS
Thirty-two patients undergoing repair of congenital heart disease with CPB and deep hypothermic circulatory arrest (DHCA) were monitored by S100B blood levels and middle cerebral artery Doppler velocimetry pulsatility index (MCA PI) before, during, and after surgical procedure at five predetermined time-points.


RESULTS
Both S100B and MCA PI significantly increased, MCA PI values exhibiting a peak at the end of surgery time-point (p > 0.05), while S100B blood levels were increased at the end of CPB (p < 0.05). Multivariate analysis, with S100B levels measured at the end of CPB as dependent variable, showed a positive significant correlation with MCA PI (p = 0.04), with the CPB and the rewarming duration (p = 0.03 and p = 0.009, respectively).


CONCLUSIONS
The present results show a significant correlation between a biochemical marker of brain damage and an index of increased cerebrovascular resistance, with higher levels during the rewarming CPB phase in pediatric open heart surgery.
Gazzolo
Diego
D
Department of Pediatrics, Giannina Gaslini Children's University Hospital, 1-16147 Genoa, Italy. dgazzolo@hotmail.com
Masetti
Paolo
P
Vinesi
Paola
P
Meli
Marco
M
Abella
Raul
R
Marcelletti
Carlo
C
Michetti
Fabrizio
F
D001810:Blood Volume / Q000502:physiology; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D005500:Follow-Up Studies; D006324:Heart Arrest, Induced; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D007036:Hypothermia, Induced; D007223:Infant; D007229:Infant Welfare; D007231:Infant, Newborn; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology; D015999:Multivariate Analysis; D009414:Nerve Growth Factors / Q000097:blood*; D017694:Rewarming; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins / Q000097:blood*; D013223:Statistics as Topic; D013997:Time Factors; D016896:Treatment Outcome; D017585:Ultrasonography, Doppler, Transcranial
D009414:Nerve Growth Factors; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins; C579160:S100B protein, human