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Intraoperative embolus formation during cardiopulmonary bypass affects the release of S100B
J Babin-Ebell1, M Misoph, W Müllges
1Department of Cardiothoracic Surgery, University Hospital, Würzburg, Germany.
Insights
S100B protein release after cardiopulmonary bypass (CPB) is linked to embolus and thrombin formation, suggesting a role for thrombofibrinous embolism in brain damage. Inflammatory markers did not influence S100B release.
Area of Science:
- Neuroscience
- Cardiovascular Surgery
- Biochemistry
Background:
- Cerebral dysfunction post-cardiopulmonary bypass (CPB) is associated with intraoperative thromboembolism and inflammation.
- Elevated S100B protein levels correlate with neuropsychological deficits after CPB.
Purpose of the Study:
- To investigate the correlation between S100B protein release and intraoperative embolus formation, thrombin generation, and inflammatory markers during CPB.
Main Methods:
- 40 patients undergoing coronary artery bypass grafting were studied.
- Blood samples analyzed for S100B, thrombin-antithrombin complex (TAT), C5a, and interleukin 8.
- Embolus formation monitored via Doppler ultrasound.
Main Results:
- S100B release significantly correlated with embolus count (r=0.42, p=0.009) and TAT formation (r=0.71, p=0.0001).
- S100B showed a correlation with interleukin 8 (r=0.58, p=0.0001), influenced by bypass time.
- No significant correlation was found between S100B and C5a formation.
Conclusions:
- S100B release is associated with embolus and thrombin formation during CPB, implicating thrombofibrinous embolism in perioperative brain injury.
- Inflammatory parameters like interleukin 8 and C5a do not appear to influence S100B release.
Background:
Intraoperative thromboembolism and the systemic inflammatory reaction are thought to play a role in causing cerebral dysfunction following cardiopulmonary bypass (CPB). Increased levels of S100B, an astroglial protein, have been linked to neuropsychological deficits after CPB. The present study investigated whether S100B release correlates with intraoperative embolus formation, thrombin formation, or the release of inflammatory parameters.
Methods:
40 patients undergoing coronary artery bypass grafting were included. Blood samples were taken before, during, and after CPB, and levels of S100B, thrombin-antithrombin complex (TAT), complement C5a, and interleukin 8 were analysed. Embolus formation was assessed by Doppler ultrasound at the arterial line of CPB.
Results:
The release of S100B correlated with embolus count (r = 0.42; p = 0.009) and TAT formation (r = 0.71; p = 0.0001). The correlation of S100B with interleukin 8 (r = 0.58; p = 0.0001) was due to the dependence of both parameters on bypass time (r = 0.29; p = 0.075, partial correlation). A correlation of S100B with C5a formation could not be observed.
Conclusions:
S100B release is related to embolus and thrombin formation during CPB, indicating that thrombofibrinous embolism is involved in perioperative brain damage. Inflammatory parameters (i.e. interleukin 8 and C5a) seem to have no influence on S100B release.