Central Nervous System Damage During Cardiac Surgery Assessed by 3 Different Biochemical Markers in Cerebrospinal Fluid

Abstract

Three cerebral biochemical markers, adenylate kinase (AK), neuron-specific enolase (NSE) and protein S-100, were determined in the cerebrospinal fluid (CSF) of male patients 24 h after coronary artery bypass grafting to investigate the extent of possible center nervous system (CNS) damage and relation to the type of oxygenator and the use of an arterial line filter. The patients were randomized into three groups for extracorporeal circulation (ECC); bubble oxygenator without an arterial line filter (Group I, n = 30), bubble oxygenator with a filter (Group II, n = 29) and a flat-sheet membrane oxygenator without a filter (Group III, n = 33). Pathologically high CSF levels of AK and NSE were found 24 h after ECC in respectively 93% and 95% of the patients. All protein S-100 concentrations were within the normal range. Isolated high CSF concentrations of AK, NSE and protein S-100 were observed in group I. Levels of AK and NSE were the lowest in group III, although there was no statistical difference between the groups. In conclusion, our study suggested that CNS damage caused by ECC involved neurons rather than glial cells. AK and NSE in the CSF seemed to be markers of ischaemic neuronal damage. Postoperative levels of biochemical markers in the CSF tended to be the lowest in the flat-sheet membrane oxygenator group.

Nerve tissue protein S‐100 and neurone‐specific enolase concentrations in cerebrospinal fluid and blood during carotid endarterectomy

“…It is increased in CSF 24 h after cardiopulmonary bypass [12] and levels tend to be higher in patients showing neurological dysfunction. In this study, there was no increase in CSF NSE.…”

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

“…Sellman et al [1992] found no relationship between high NSE levels and postoperative brain damage. Isgro et al [1997], suggested that high NSE levels after open-heart surgery are followed by brain damage installation and Hardemark et al in 1988 and, found a quantitative relationship between the NSE levels and the severity of the postoperative brain damage [Hardemark et al, 1988[Hardemark et al, , 1989.…”

“…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.…”

Real-Time Monitoring of Bodily Fluids Using a Novel Electromagnetic Wave Sensor

“…There are two reasons for this: (1) lactate is relatively inexpensive and (2) CSF provides a relatively simple background which can be synthesised in-vitro. A small sample volume of 0.5 ml, which is enough to saturate the internal cavity volume, is placed in a glass tube (0.5 mm diameter and 180 mm in length).…”

“…This is supported by work conducted by Drenger et al [8], who observed that lactate concentration in CSF increased with the onset of patient paraplegia. Three cerebral biochemical markers, adenylate kinase (AK), neuron-specific enolase (NSE) and protein S-100 can be determined in the CSF after coronary artery bypass grafting [1]. Moreover, protein S-100B, neuron-specific enolase, myelin basic protein and glial fibrillary acidic protein in CSF and blood of patients with an acute or chronic progressive neurological disorder with brain damage are important indicators for medical practitioners.…”