Changes in cerebral oxygen saturation correlate with s100b in infants undergoing cardiac surgery with cardiopulmonary bypass

Samer Abu-Sultaneh, David A. Hehir, Kathleen Murkowski, Nancy S. Ghanayem, Jennifer L. Liedel, Raymond G. Hoffmann, Yumei Cao, Michael E. Mitchell, Andreas Jeromin, James S. Tweddell, George M. Hoffman

Research output: Contribution to journalArticle

12 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)219-228
Number of pages10
JournalPediatric Critical Care Medicine
Volume15
Issue number3
DOIs
StatePublished - 2014
Externally publishedYes

Fingerprint

Cardiopulmonary Bypass
Thoracic Surgery
Oxygen
Near-Infrared Spectroscopy
Cyanosis
Serum
Extracorporeal Membrane Oxygenation
Perioperative Period
Brain Injuries
Heart Diseases
Cohort Studies
Anesthesia
Biomarkers
Enzyme-Linked Immunosorbent Assay
Prospective Studies
Wounds and Injuries

Keywords

  • biomarkers of brain injury
  • cardiopulmonary bypass
  • cerebral saturation
  • congenital heart disease
  • near-infrared spectroscopy
  • S100B

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Critical Care and Intensive Care Medicine
  • Medicine(all)

Cite this

Changes in cerebral oxygen saturation correlate with s100b in infants undergoing cardiac surgery with cardiopulmonary bypass. / Abu-Sultaneh, Samer; Hehir, David A.; Murkowski, Kathleen; Ghanayem, Nancy S.; Liedel, Jennifer L.; Hoffmann, Raymond G.; Cao, Yumei; Mitchell, Michael E.; Jeromin, Andreas; Tweddell, James S.; Hoffman, George M.

In: Pediatric Critical Care Medicine, Vol. 15, No. 3, 2014, p. 219-228.

Research output: Contribution to journalArticle

Abu-Sultaneh, S, Hehir, DA, Murkowski, K, Ghanayem, NS, Liedel, JL, Hoffmann, RG, Cao, Y, Mitchell, ME, Jeromin, A, Tweddell, JS & Hoffman, GM 2014, 'Changes in cerebral oxygen saturation correlate with s100b in infants undergoing cardiac surgery with cardiopulmonary bypass', Pediatric Critical Care Medicine, vol. 15, no. 3, pp. 219-228. https://doi.org/10.1097/PCC.0000000000000055
Abu-Sultaneh, Samer ; Hehir, David A. ; Murkowski, Kathleen ; Ghanayem, Nancy S. ; Liedel, Jennifer L. ; Hoffmann, Raymond G. ; Cao, Yumei ; Mitchell, Michael E. ; Jeromin, Andreas ; Tweddell, James S. ; Hoffman, George M. / Changes in cerebral oxygen saturation correlate with s100b in infants undergoing cardiac surgery with cardiopulmonary bypass. In: Pediatric Critical Care Medicine. 2014 ; Vol. 15, No. 3. pp. 219-228.
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AU - Abu-Sultaneh, Samer

AU - Hehir, David A.

AU - Murkowski, Kathleen

AU - Ghanayem, Nancy S.

AU - Liedel, Jennifer L.

AU - Hoffmann, Raymond G.

AU - Cao, Yumei

AU - Mitchell, Michael E.

AU - Jeromin, Andreas

AU - Tweddell, James S.

AU - Hoffman, George M.

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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 - biomarkers of brain injury

KW - cardiopulmonary bypass

KW - cerebral saturation

KW - congenital heart disease

KW - near-infrared spectroscopy

KW - S100B

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