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J Thorac Cardiovasc Surg 2000;119:132-137
© 2000 Mosby, Inc.
CARDIOPULMONARY SUPPORT AND PHYSIOLOGY |
From Oxford Heart Centre, John Radcliffe Hospital,a Oxford, United Kingdom, Department of Biomedical Engineering, University of Groningen, The Netherlands,b and University Department of Experimental Psychology, Oxford, United Kingdom.c
Financial support was received from Cobe Cardiovascular, Inc, Arvada, Colo. Haemoprobe, Groningen, The Netherlands, performed the S-100ß analysis.
Address for reprints: S. Westaby, BSc, FRCS, MS, Oxford Heart Centre, John Radcliffe Hospital, Oxford OX3 9DU, England.
Objectives: Over the past decade, the glial protein S-100ß has been used to detect cerebral injury in a number of clinical settings including cardiac surgery. Previous investigations suggest that S-100ß is capable of identifying patients with cerebral dysfunction after cardiopulmonary bypass. Whether detection of elevated levels S-100ß reflects long-term cognitive impairment remains to be shown. The present study evaluated whether perioperative release of S-100ß after coronary artery operations with cardiopulmonary bypass could predict early or late neuropsychologic impairment.
Methods: A total of 100 patients undergoing elective coronary bypass without a previous history of neurologic events were prospectively studied. To exclude noncerebral sources of S-100ß, we did not use cardiotomy suction or retransfusion of shed mediastinal blood. Serial perioperative measurements of S-100ß were performed with the use of a new sensitive immunoluminometric assay up to 8 hours after the operation. Patients underwent cognitive testing on a battery of 11 tests before the operation, before discharge from the hospital, and 3 months later.
Results: No significant correlation was found between S-100ß release and neuropsychologic measures either 5 days or 3 months after the operation.
Conclusion: Despite using a sensitive immunoluminometric assay of S-100ß, we found no evidence to support the suggestion that early release of S-100ß may reflect long-term neurologic injury capable of producing cognitive impairment.
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