title: Perioperative erythropoietin protects the CNS against ischemic lesions in patients after open heart surgery.
abstract: OBJECTIVE
  The aim of this study was to establish erythropoietin as a protective factor against brain ischemia during open heart surgery.
  
  
  METHODS
  A total of 36 consecutive patients scheduled for revascularization heart surgery were included in the study. Of the patients 18 received 3 intravenous doses of recombinant human erythropoietin (rHuEpo, 24,000 IU) and 18 patients received a placebo. Magnetic resonance imaging (MRI) to detect new brain ischemic lesions was performed. Additionally, S100A, S100B, neuron-specific enolase A and B (NSE-A and B) and the concentration of antibodies against N‑methyl-D-aspartate receptors (NMDAR) to identify new neurological complications were determined.
  
  
  RESULTS
  Patients who received rHuEpo showed no postoperative ischemic changes in the brain on MRI images. In the control group 5 (27.8 %) new ischemic lesions were found. The NMDAR antibody concentration, S100A, S100B and NSE showed no significant differences between the groups for new cerebral ischemia. High levels of lactate before and after external aortic compression (p = 0.022 and p = 0.048, respectively) and duration of operation could predict new ischemic lesions (p = 0.009).
  
  
  CONCLUSIONS
  The addition of rHuEpo reduced the formation of lesions detectable by MRI in the brain and could be used clinically as neuroprotection in cardiac surgery.
authors: Department for Cardiovascular Surgery, University Medical Centre Ljubljana, Ljubljana, Slovenia.
authors: Nikola
authors: N
authors: Lakič
authors: Department of Cardiology, University Medical Centre Ljubljana, Zaloška cesta 7, 1000, Ljubljana, Slovenia.
authors: Miha
authors: M
authors: Mrak
authors: Department of Cardiology, University Medical Centre Ljubljana, Zaloška cesta 7, 1000, Ljubljana, Slovenia.
authors: Miha
authors: M
authors: Šušteršič
authors: Department of Cardiology, University Medical Centre Ljubljana, Zaloška cesta 7, 1000, Ljubljana, Slovenia.
authors: Peter
authors: P
authors: Rakovec
authors: Department of Cardiology, University Medical Centre Ljubljana, Zaloška cesta 7, 1000, Ljubljana, Slovenia. mbuncek@yahoo.com.
authors: Matjaž
authors: M
authors: Bunc
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000000981:diagnostic imaging / Q000209:etiology* / Q000517:prevention & control*; D006348:Cardiac Surgical Procedures; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D004311:Double-Blind Method; D004921:Erythropoietin / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D018696:Neuroprotective Agents / Q000008:administration & dosage; D015990:Placebo Effect; D011292:Premedication; D011300:Preoperative Care / Q000379:methods; D011379:Prognosis; D011446:Prospective Studies; D013908:Thoracotomy / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D018696:Neuroprotective Agents; D004921:Erythropoietin
keywords: Erythropoietin; Ischemic lesions; Magnetic resonance imaging; Neurologic dysfunction; Open heart surgery