Faculty Collaboration Database

Changes in cerebral oxygen saturation correlate with S100B in infants undergoing cardiac surgery with cardiopulmonary bypass. Pediatr Crit Care Med 2014 Mar;15(3):219-28

Date

12/25/2013

Pubmed ID

24366505

DOI

10.1097/PCC.0000000000000055

Scopus ID

2-s2.0-84896398976 (requires institutional sign-in at Scopus site)   23 Citations

Abstract

OBJECTIVES: The relationship of cerebral saturation measured by near-infrared spectroscopy with serum biomarker of brain injury S100B was investigated in infants undergoing cardiac surgery with cardiopulmonary bypass.

DESIGN: Prospective cohort study.

SETTING: Single-center children's hospital.

PATIENTS: Forty infants between 1 and 12 months old weighing greater than or equal to 4 kg with congenital heart disease undergoing cardiac surgery with cardiopulmonary bypass were enrolled.

INTERVENTIONS: None.

MEASUREMENTS AND MAIN RESULTS: Serum S100B was measured at eight time points over 72 hours using enzyme-linked immunosorbent assay. Physiologic data including arterial, cerebral, and somatic regional oxygen saturations measured by near-infrared spectroscopy were synchronously recorded at 1-minute intervals from anesthesia induction through 72 postoperative hours. The arterial-cerebral oxygen saturation difference was calculated as the difference between arterial saturation and cerebral regional saturation. Thirty-eight patients, 5.4 ± 2.5 months old, were included in the analysis; two were excluded due to the use of postoperative extracorporeal membrane oxygenation. Seventeen patients (44.7%) had preoperative cyanosis. S100B increased during cardiopulmonary bypass in all patients, from a median preoperative baseline of mean ± SE: 0.055 ± 0.038 to a peak of 0.610 ± 0.038 ng/mL, p less than 0.0001. Patients without preoperative cyanosis had a higher S100B peak at the end of cardiopulmonary bypass. Although the absolute cerebral regional saturation on cardiopulmonary bypass was not associated with S100B elevation, patients who had arterial-cerebral oxygen saturation difference greater than 50 at any time during cardiopulmonary bypass had a higher S100B peak (mean ± SE: 1.053 ± 0.080 vs 0.504 ± 0.039 ng/mL; p < 0.0001).

CONCLUSIONS: A wide cerebral arteriovenous difference measured by near-infrared spectroscopy during cardiopulmonary bypass is associated with increased serum S100B in the perioperative period and may be a modifiable risk factor for neurological injury.

Author List

Abu-Sultaneh S, Hehir DA, Murkowski K, Ghanayem NS, Liedel J, Hoffmann RG, Cao Y, Mitchell ME, Jeromin A, Tweddell JS, Hoffman GM

Authors

George M. Hoffman MD Chief, Professor in the Anesthesiology department at Medical College of Wisconsin
Michael Edward Mitchell MD Chief, Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Brain
Cardiac Surgical Procedures
Cardiopulmonary Bypass
Cerebrovascular Circulation
Cohort Studies
Enzyme-Linked Immunosorbent Assay
Female
Heart Defects, Congenital
Hospitals, Pediatric
Humans
Infant
Male
Oxygen
Prospective Studies
S100 Calcium Binding Protein beta Subunit
Spectroscopy, Near-Infrared