Comparison of hydroxyethyl starch and ringer lactate as a prime solution regarding S-100beta protein levels and informative cognitive tests in cerebral injury.
BACKGROUND
Cognitive dysfunction (as an indicator of cerebral dysfunction after open heart surgery) was observed in as many as 70% of patients who underwent cardiopulmonary bypass. S-100beta protein is a sensitive indicator of cerebral injury. We aimed to compare the effects of hydroxyethyl starch and Ringer lactate prime solutions in the protection of cerebral tissue in cardiopulmonary bypass using serum S-100beta protein levels and informative cognitive tests.


METHODS
Patients were randomized into two groups. Open heart surgery was performed by using hydroxyethyl starch solution in group 1 (n = 15) and Ringer lactate solution in group 2 (n = 15). Preoperative, perioperative, and postoperative S-100beta protein levels and informative cognitive test scores, clinical and operational characteristics of the patients were compared.


RESULTS
A significant difference was found only between preoperative and postoperative results of verbal accuracy (human) test in group 1, whereas differences between preoperative and postoperative scores of continuous skill, verbal accuracy (human), verbal accuracy (animal), verbal accuracy (human-animal), go-no-go paradigm, calculation, and abstract thinking tests were significant in group 2 (p < or = 0.05). The S-100beta protein levels were not significantly different between the groups (group p = 0.97).


CONCLUSIONS
Because hydroxyethyl starch prime solution used in extracorporeal circulation had significant positive effects with informative-cognitive tests when compared to Ringer lactate solution, it seems to be a better prime solution to prevent cerebral dysfunction in these patients.
Iriz
Erkan
E
Department of Cardiovascular Surgery, School of Medicine, Gazi University, Ankara, Turkey. erkaniriz@hotmail.com
Kolbakir
Fersat
F
Akar
Haci
H
Adam
Bahattin
B
Keceligil
Hasan Tahsin
HT
D002315:Cardiopulmonary Bypass / Q000009:adverse effects / Q000379:methods*; D003071:Cognition / Q000187:drug effects*; D003072:Cognition Disorders / Q000209:etiology / Q000517:prevention & control; D005112:Extracorporeal Circulation / Q000379:methods*; D005260:Female; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000494:pharmacology*; D007552:Isotonic Solutions / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D011182:Postoperative Care; D011300:Preoperative Care; D000077325:Ringer's Lactate; D009418:S100 Proteins / Q000378:metabolism*
D006895:Hydroxyethyl Starch Derivatives; D007552:Isotonic Solutions; D000077325:Ringer's Lactate; D009418:S100 Proteins