title: Predictors of Ominous Outcome in Infants who Undergo Cardiac Surgery and Cardiopulmonary By-Pass: S100B Protein.
abstract: S100B protein has been recently proposed as a consolidated marker of brain damage and death in adult, children and newborn patients. The present study evaluates whether the longitudinal measurement of S100B at different perioperative time-points may be a useful tool to identify the occurrence of perioperative early death in congenital heart disease (CHD) newborns. We conducted a case-control study in 88 CHD infants, without pre-existing neurological disorders or other co-morbidities, of whom 22 were complicated by perioperative death in the first week from surgery. Control group was composed by 66 uncomplicated CHD infants matched for age at surgical procedure. Blood samples were drawn at five predetermined timepoints before during and after surgery. In all CHD children, S100B levels showed a pattern characterized by a significant increase in protein's concentration from hospital admission up to 24-h after procedure reaching their maximum peak (P<0.01) during cardiopulmonary by-pass and at the end of the surgical procedure. Moreover, S100B concentrations in CHD death group were significantly higher (P<0.01) than controls at all monitoring time-points. The ROC curve analysis showed that S100B measured before surgical procedure was the best predictor of perioperative death, among a series of clinical and laboratory parameters, reaching at a cut-off of 0.1 µg/L a sensitivity of 100% and a specificity of 63.7%. The present data suggest that in CHD infants biochemical monitoring in the perioperative period is becoming possible and S100B can be included among a series of parameters for adverse outcome prediction.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Varrica
authors.forename: Angela
authors.initials: A
authors.lastname: Satriano
authors.forename: Guido
authors.initials: G
authors.lastname: Tettamanti
authors.forename: Gabriele
authors.initials: G
authors.lastname: Pelissero
authors.forename: Antonio D W
authors.initials: AD
authors.lastname: Gavilanes
authors.forename: Luc J
authors.initials: LJ
authors.lastname: Zimmermann
authors.forename: Hans J S
authors.initials: HJ
authors.lastname: Vles
authors.forename: Pasquale
authors.initials: P
authors.lastname: Florio
authors.forename: Francesca R
authors.initials: FR
authors.lastname: Pluchinotta
authors.affiliation: Department of Maternal Fetal and Neonatal Medicine, C. Arrigo Children's Hospital, Spalto Marengo 46, I-15100 Alessandria, Italy. dgazzolo@hotmail.com.
authors.forename: Diego
authors.initials: D
authors.lastname: Gazzolo
mesh_terms: D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D016022:Case-Control Studies; D005260:Female; D006330:Heart Defects, Congenital / Q000097:blood / Q000401:mortality / Q000601:surgery; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D009422:Nervous System Diseases / Q000209:etiology*; D011183:Postoperative Complications / Q000453:epidemiology / Q000401:mortality*; D012044:Regression Analysis; D009418:S100 Proteins / Q000097:blood*; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
chemical_list: D009418:S100 Proteins