TY - JOUR
T1 - Changes in cerebral oxygen saturation correlate with s100b in infants undergoing cardiac surgery with cardiopulmonary bypass
AU - Abu-Sultaneh, Samer
AU - Hehir, David A.
AU - Murkowski, Kathleen
AU - Ghanayem, Nancy S.
AU - Liedel, Jennifer
AU - Hoffmann, Raymond G.
AU - Cao, Yumei
AU - Mitchell, Michael E.
AU - Jeromin, Andreas
AU - Tweddell, James S.
AU - Hoffman, George M.
PY - 2014/3
Y1 - 2014/3
N2 - 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.
AB - 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.
KW - S100B
KW - biomarkers of brain injury
KW - cardiopulmonary bypass
KW - cerebral saturation
KW - congenital heart disease
KW - near-infrared spectroscopy
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U2 - 10.1097/PCC.0000000000000055
DO - 10.1097/PCC.0000000000000055
M3 - Article
C2 - 24366505
AN - SCOPUS:84896398976
SN - 1529-7535
VL - 15
SP - 219
EP - 228
JO - Pediatric Critical Care Medicine
JF - Pediatric Critical Care Medicine
IS - 3
ER -