A pilot study of evaluation of cerebral function by S100beta protein and near-infrared spectroscopy during cold and warm cardiopulmonary bypass in infants and children undergoing open-heart surgery.
Cerebral injury in children undergoing cardiopulmonary bypass (CPB) remains a major source of morbidity. The effect of cardiopulmonary bypass temperature on cerebral function in terms of serum S100beta protein level and cerebral oxygenation monitored by near infrared spectroscopy (NIRO-300) in children is not known. In this study, 18 children undergoing open-heart surgery at the Hospital for Sick Children in London were equally assigned by minimisation to warm (35 +/- 1 degrees C) or cold (25 +/- 1 degrees C) CPB. Changes in S100beta protein and cerebral oxygenation were studied in both groups. S100beta protein serum level increased significantly after CPB in both groups. There was no significant difference in serum S100beta protein concentrations between the two groups. However, cerebral oxygenation in terms of tissue oxygen index (TOI) was significantly impaired during rewarming from cold CPB. Five patients were desaturated (TOI < 50%) during rewarming in the cold bypass group compared to two in the warm patients. This study supports the use of warm CPB in children undergoing open-heart surgery, although further studies recruiting more patients are warranted.
Shaaban Ali
M
M
Lecturer of Anaesthesia, Department of Anaesthesia, Assiut University Hospital, Assiut, BO Box 71111, Egypt. msali58@hotmail.com
Harmer
M
M
Elliott
M
M
Thomas
A Lloyd
AL
Kirkham
F
F
D015415:Biomarkers / Q000097:blood; D001921:Brain / Q000378:metabolism; D002315:Cardiopulmonary Bypass / Q000379:methods*; D002675:Child, Preschool; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D007036:Hypothermia, Induced; D002534:Hypoxia, Brain / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control; D007223:Infant; D007431:Intraoperative Complications / Q000175:diagnosis / Q000517:prevention & control; D008297:Male; D009414:Nerve Growth Factors / Q000097:blood*; D010101:Oxygen Consumption; D010865:Pilot Projects; D017694:Rewarming; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins / Q000097:blood*; D019265:Spectroscopy, Near-Infrared
D015415:Biomarkers; D009414:Nerve Growth Factors; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins