Assessment of Cerebral Damage During Open-Heart Surgery a New Experimental Model

Abstract

A new experimental technique for the assessment of cerebral cellular damage during extracorporeal circulation is described. It is based upon the direct measurement of the enzyme creatine phosphokinase (CPK) and the brain-specific isoenzyme CPK-B in cerebrospinal fluid of dogs submitted to conventional techniques of cardiopulmonary bypass (CPB). Highly significant elevations occur during a 60 min period of CPB in CSF levels of total CPK and CPK-B isoenzyme. These elevated levels persist at 24 hours postoperation, despite full clinical recovery in the dogs. In a comparative study of the effects of introducing a 40 micrometer arterial line screen filter during the period of CPB, there was a highly significant reduction in total CPK and CPK-B levels in the filtered group (p < 0.005).

The impact of microemboli during cardiopulmonary bypass on neuropsychological functioning.

“…In dogs a rise in cerebrospinal fluid brain creatine phosphokinase can be demonstrated during CPB. 9 This rise is almost entirely eliminated when arterial line filters are used, suggesting a marked reduction in brain cell damage. Wilner et al 10 studied the effect of different arterial line filters on neuropsychological outcome, using the Conceptual Levels Analogy Test.…”

Neuron Specific Enolase (NSE): A Valuable Prognostic Factor of Central Nervous System Dysfunction Following Cardiac Surgery

“…CK-BB [Taylor et al, 1980] is a predictive biochemical marker used by some investigators, but has not proved as reliable as NSE as it creates frequent cross-reactions to other isoenzymes. Eventually, it seems that the detection of blood serum NSE is the most accurate and reliable factor available for early prognosis of brain dysfunction following open-heart surgery .…”

“…A large number of different agents and biomarkers have been occasionally used for the prognosis of postoperative brain damage during cardiac surgery. The S100 protein [Sellman et al, 1992], AK [Aberg et al, 1984], CK-BB [Taylor et al, 1980] are some of them used with moderate results.…”

Spallation of Dialysis Materials – Problems and Perspectives

“…Brain dysfunction after open heart surgery was related to particle microembo lism [19]. Taylor et al [20] noted an increase of cerebrospinal fluid creatinine kinase after open heart surgery; such increase was prevented when a micropore filter was added to the extracorporeal circuit to prevent microembolism.…”