title: Delayed rises in serum S100B levels and adverse neurological outcome in infants and children undergoing cardiopulmonary bypass.
abstract: BACKGROUND
  The protein S100B is a marker of brain injury. Early after cardiopulmonary bypass (CPB), serum S100B levels are artefactually high. We investigated whether delayed (48 h) rise in S100B levels may have a role in detecting brain injury after CPB.
  
  
  METHODS
  Data from 43 children were analysed in this study. Samples were collected at preincision and 30 min, 24 and 48 h postbypass and then analysed by using a commercially available radioimmunoassay (Sangtec100). Charts were reviewed at 3-5 months for evidence of neurological injury.
  
  
  RESULTS
  S100B levels were high preoperatively in neonates and universally high immediately postbypass. In 36 children, samples were available for all time points. Compared with preoperative levels, rises occurred at both 24 and 48 h in three patients, only at 24 h in four patients and only at 48 h in three patients. Two patients had evidence of neurological injury. A rise at 48 h was associated with neurological injury (odds ratio 33.9, P < 0.03, 95% CI 1.39-827). There was no association between neurological injury and S100B levels at 24 h. Both the patients with neurological injury had rises at 48 h that were significantly higher than patients with rises at 48 h without injury.
  
  
  CONCLUSIONS
  The results of this study suggest that monitoring S100B levels in the late postoperative period may still have a role in detecting neurological injury after cardiac surgery in children. Consistent with previous observations, S100B is high preoperatively in neonates and early postbypass in all patients.
authors.affiliation: Department of Anaesthesia, Children's Hospital, Calgary, Alberta, Canada.
authors.forename: David
authors.initials: D
authors.lastname: Lardner
authors.forename: Andrew
authors.initials: A
authors.lastname: Davidson
authors.forename: Ian
authors.initials: I
authors.lastname: McKenzie
authors.forename: Andrew
authors.initials: A
authors.lastname: Cochrane
mesh_terms: D015415:Biomarkers / Q000097:blood; D001927:Brain Diseases / Q000175:diagnosis / Q000209:etiology*; D001930:Brain Injuries / Q000097:blood / Q000175:diagnosis / Q000209:etiology; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D007223:Infant; D009414:Nerve Growth Factors; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins / Q000097:blood*
chemical_list: D015415:Biomarkers; D009414:Nerve Growth Factors; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins; C579160:S100B protein, human