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Early release pattern of S100 protein as a marker of brain damage after warm cardiopulmonary bypass
M Shaaban Ali1, M Harmer, R S Vaughan
1Department of Anaesthetics and Intensive Care Medicine, University of Wales College of Medicine, Heath Park, Cardiff CF14 4XN, UK.
Insights
Warm cardiopulmonary bypass with warm blood cardioplegia may cause early brain S100 protein release, an indicator of brain damage. Peak S100 levels correlate with patient age, suggesting age is a factor in monitoring brain injury after surgery.
Area of Science:
- Cardiovascular Surgery
- Neuroscience
- Biomarkers
Background:
- The neurological effects of warm cardiopulmonary bypass (CPB) and warm blood cardioplegia are debated.
- S100 protein is an established early marker for brain damage, detected previously after cold CPB.
Purpose of the Study:
- To investigate S100 protein concentrations in patients undergoing coronary artery bypass surgery (CABG) with warm CPB and warm blood cardioplegia.
- To determine the relationship between S100 protein levels and patient age following this procedure.
Main Methods:
- Studied 20 patients undergoing CABG.
- Measured S100 protein levels before and immediately after warm CPB (34-37°C) with warm blood cardioplegia (37°C).
- Analyzed the correlation between peak S100 levels and patient age.
Main Results:
- Peak S100 protein levels were observed immediately after warm CPB, followed by a progressive decrease over 4.5 hours.
- A significant positive correlation was found between peak S100 protein concentration and patient age (y = -3.2 + 0.08x).
Conclusions:
- Warm CPB and warm blood cardioplegia are associated with an early release of S100 protein.
- Patient age is a critical factor influencing S100 protein levels post-CPB and should be considered in future research and clinical assessments.
Abstract:
Warm blood cardioplegia may be more beneficial to the heart than cold cardioplegia, but the effects of warm cardiopulmonary bypass and warm blood cardioplegia on the brain are controversial. S100 protein is an early marker of brain damage and has been detected after cold cardiopulmonary bypass. We studied S100 concentrations in 20 patients undergoing coronary artery bypass surgery before and after warm cardiopulmonary bypass (34-37 degrees C) using warm blood cardioplegia (37 degrees C) for all patients. The peak level of S100 protein occurred immediately after warm cardiopulmonary bypass, then decreased progressively until the last measurement at 4.5 h after bypass. The peak level appears to be dependent upon the age of the patient, with the following regression equation: y = -3.2 + 0.08x, where y is S100 protein concentration in microg.l-1 and x is patient age in years. Further studies are needed to investigate the clinical significance of this early release pattern. Patient age should be taken into account when studying S100 protein levels after cardiopulmonary bypass.
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