Is there a relationship between serum S-100β protein and neuropsychologic dysfunction after cardiopulmonary bypass?

Westaby, Stephen; Saatvedt, Kjell; White, Sno E.; Katsumata, Takahiro; Oeveren, van Willem; Bhatnagar, NK; Brown, Scott M.; Halligan, PW

doi:10.1016/s0022-5223(00)70228-5

Cited by 61 publications

(52 citation statements)

References 24 publications

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“…The underlying mechanism of this gradual elevation is multifactorial. Reversible injury of the Schwann cells and glial cells increases the permeability of the BBB [9][10][11], and extracerebral contamination [7,8] may also play a role. Although S100ß is an unquestionable marker of brain injury [5,6], it is still unclear why S100ß increases during CPB without neurologic sequelae.…”

Section: Discussionmentioning

confidence: 99%

“…However, the early increase in serum S100ß during cardiopulmonary bypass (CPB) is unlikely to be associated with clinically detectable brain injury [6]. Extracerebral contamination [7,8], increased permeability of the blood-brain barrier (BBB) related to inflammatory responses [9][10][11], and changes in the rate of elimination through the kidney may explain this discrepancy [12]. -4 -significantly higher than those in the artery in patients with severe head injury [13].…”

Section: Introductionmentioning

confidence: 99%

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Arterio-jugular Differences in Serum S-100β Proteins in Patients Receiving Selective Cerebral Perfusion

et al. 2005

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Arterio-jugular Differences in Serum S-100β Proteins in Patients Receiving Selective Cerebral Perfusion

et al. 2005

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“…S-100ß subunits are present in glial and Schwann cells and, recently, elevated levels have been detected after cardiac operations complicated by neurological injury. 4,5 The appearance of S-100ß in serum indicates both neuronal damage and increased permeability of the blood-brain barrier. 6 Neuropsychological testing is one of the best methods currently available for assessing changes in intellectual function after a cerebral insult and has identified persistent mild, moderate or severe deterioration in 19% to 38% of patients who undergo CPB.…”

Section: Ficativement éLevés Dans Le Groupe P De Notre éTude Aucune mentioning

confidence: 99%

Propofol offers no advantage over isoflurane anesthesia for cerebral protection during cardiopulmonary bypass: a preliminary study of S-100ß protein levels

Kanbak

Saricaoglu

Avci

et al. 2004

Can J Anesth/J Can Anesth

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P Pu ur rp po os se e: : Despite advances in anesthesia, cardiopulmonary bypass (CPB) and surgical techniques, cerebral injury remains a major source of morbidity after cardiac surgery. We compared the effects of two different anesthetic techniques, isoflurane vs propofol on neurological outcome by serum S-100ß protein and neuropsychological tests after coronary artery bypass grafting (CABG).M Me et th ho od ds s: : Twenty patients undergoing CABG, randomly allocated into two groups, were enrolled in this prospective, controlled, preliminary study. Isoflurane was used in group I and propofol in group P. Neurological examination and a neuropsychologic test battery consisting of the mini mental state examination (MMSET) and the visual aural digit span test (VADST) were obtained preoperatively and on the third and sixth postoperative days. Blood samples for analysis of S-100ß protein were collected before anesthesia (T1), after heparinization (T2), 15 min into CPB (T3), after CPB (T4) and at the 24 th hr postoperatively (T5).R Re es su ul lt ts s: : Postoperative neurological examinations of the patients were normal. VADST performance declined significantly on the third day (P < 0.05) in both groups, and there were no significant differences on VADST and MMSET scores between the two groups. In group P, S-100ß protein levels increased significantly at T3 and T4 compared to preoperative and isoflurane levels (P < 0.05).C Co on nc cl lu us si io on ns s: : Despite reports about the neuroprotective effects of propofol, S-100ß protein levels were significantly elevated in group P. Although there was no deterioration in neuropsychological outcome, propofol appeared to offer no advantage over isoflurane for cerebral protection during CPB in this preliminary study of 20 patients. C Ca ar rd di io ot th ho or ra ac ci ic c A An ne es st th he es si ia a, , R Re es sp pi ir ra at ti io on n a an nd d A Ai ir rw wa ay y Propofol offers no advantage over isoflurane anesthesia for cerebral protection during cardiopulmonary bypass: a preliminary study of S-100ß protein levels [L'anesthésie au propofol, comparé à l'isoflurane, n'a Objectif : Malgré les progrès de l'anesthésie, la circulation extracorporelle (CEC) et les techniques chirurgicales, les lésions cérébrales demeurent une importante source de morbidité postchirurgie cardiaque. Les effets neurologiques comparés de l'isoflurane et du propofol sont présentés par l'analyse des protéines sériques S-100ß et des test neuropsychologiques après un pontage aortocoronarien (PAC). Méthode : Notre étude préliminaire, prospective et contrôlée a porté sur 20 patients, répartis au hasard en deux groupes, qui devaient subir un PAC. L'isoflurane a été utilisé dans le groupe I et le propofol dans le groupe P. L'examen neurologique et une batterie de tests neuropsychologiques, comprenant le mini-examen de l'état mental (MMSET pour mini mental state examination) et le test visuel et auditif de mémoire des chiffres (VADST pour visual aural digit span test), ont été réalisés avant l'opérat...

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“…7 However, in another study, after OPCAB surgery with lower amounts of mental emboli, the increase of S100 was reduced compared with conventional CPB. 8,9 In the present trial, OPCAB surgery was done with the no-touch aortic technique to prevent embolic events and stroke in elderly patients.…”

mentioning

confidence: 99%

“…Postoperative fluid management is also simplified because of reduced third space sequestration. 9 Beating heart surgery requires the anesthetist to pro-actively maintain stable hemodynamics and rhythm in an environment that changes rapidly because of regional ischemia and cardiac manipulation. Adequate premedication is required, and tachycardia should be avoided to prevent an imbalance between oxygen demand and supply.…”

mentioning

confidence: 99%

Effect of Different Anesthetic Techniques on Mental Outcome in Elderly Patients Undergoing Off-Pump Coronary Artery Bypass Graft Surgery

Özer¹,

Yilmaz²

2017

Turkiye Klinikleri J Cardiovasc Sci

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A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : In this article, we aimed to test the hypothesis that maintenance of hemodynamic stability with anesthesia and no-touch aortic technique in off-pump coronary artery bypass graft surgery (CABG) may diminish postoperative mental complications in elderly patients. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : Between June 2009 and December 2009, 88 elderly patients (53 males, 35 females; mean age 71±7 years; range 64 to 78 years) with a physical status of ASA II-III who underwent elective off-pump CABG surgery in our hospital's operating rooms and cardiovascular and thoracic intensive care units were included in this prospective randomized study with signed informed consents. Patients undergoing off-pump CABG surgery performed by a surgeon were randomly assigned into two groups, including total intravenous anesthesia (group TIVA, n=40; mean age 66±4) or inhalational anesthesia (group IA, n=40; mean age 69±3). The effect of off-pump CABG surgery on mental outcome was assessed with S100 protein, a neurochemical marker of brain injury under ischemic conditions. Comparison of mental function before and after off-pump CABG surgery, hemodynamic stability and time to discharge were the main outcomes of the study. R Re es su ul lt ts s: : Hemodynamic values were stable in both groups. None of the patients showed marked increase in serum concentrations of S100 postoperatively (p<0.001). The mean total off-pump CABG time was 48±15 minutes in both groups. There was no difference between the groups in terms of time to discharge. C Co on nc cl lu us si io on n: : We believe that well-performed hemodynamic stability with either intravenous or general anesthesia may offer a well-controlled mental function in elderly patients undergoing offpump CABG surgery. K Ke ey yw wo or rd ds s: : Coronary artery bypass, off-pump; coronary artery bypass; anesthetics, inhalation; anesthetics, intravenous Ö ÖZ ZE ET T A Am ma aç ç: : Bu çalışmada, atan kalpteki koroner arter baypas greft (KABG) cerrahisinde hemodinamik stabilitenin anestezi, iyi premedikasyon ve dokunmasız aort tekniğiyle sağlanmasının yaşlı-larda ameliyat sonrası zihinsel komplikasyonları azaltabileceği hipotezi test edildi. G Ge er re eç ç v ve e Y Yö ön n--t te em ml le er r: : Haziran-Aralık 2009 tarihleri arasında, hastanemizin ameliyathaneleri ve kardiyovasküler ve torasik yoğun bakım ünitelerinde elektif olarak atan kalpte KABG cerrahisi geçiren ve fiziksel durumu ASA II-III olan 88 yaşlı hasta (53 erkek, 35 kadın; ortalama yaş 71± 7yıl; dağılım aralığı 64 ile 78 yıl) bilgilendirilmiş onam alınarak bu prospektif ve randomize çalışmaya dahil edildi. Tek cerrah tarafından yürütülen atan kalpte KABG cerrahisi geçiren hastalar total intravenöz anestezi (grup TIVA, n=40; ortalama yaş 66±4) veya inhalasyon anestezisi (grup IA, n=40; ortalama yaş 69±3) olmak üzere iki gruba ayrıldı. Atan kalpte KABG cerrahisinin beyindeki sonuçları iskemik durumlarda nörokimyasal belirteç olan S100 proteini ile değerlendiril...

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Is there a relationship between serum S-100β protein and neuropsychologic dysfunction after cardiopulmonary bypass?

Abstract: Despite using a sensitive immunoluminometric assay of S-100beta, we found no evidence to support the suggestion that early release of S-100beta may reflect long-term neurologic injury capable of producing cognitive impairment.

Cited by 61 publications

References 24 publications

Arterio-jugular Differences in Serum S-100β Proteins in Patients Receiving Selective Cerebral Perfusion

Arterio-jugular Differences in Serum S-100β Proteins in Patients Receiving Selective Cerebral Perfusion

Propofol offers no advantage over isoflurane anesthesia for cerebral protection during cardiopulmonary bypass: a preliminary study of S-100ß protein levels

Effect of Different Anesthetic Techniques on Mental Outcome in Elderly Patients Undergoing Off-Pump Coronary Artery Bypass Graft Surgery

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