Serologic Markers of Brain Injury and Cognitive Function After Cardiopulmonary Bypass
- 1 January 2006
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Transactions of the ... Meeting of the American Surgical Association
- Vol. 124 (4), 258-266
- https://doi.org/10.1097/01.sla.0000239087.00826.b4
Abstract
To examine the association between biochemical markers of brain injury (MBI) and the inflammatory response in relation to neurocognitive deficiency (NCD) after cardiopulmonary bypass (CPB).In cardiac surgery, NCD is a common but underdiagnosed complication with an unclear pathophysiology leading to significant morbidity. Despite extensive investigation, identification of a MBI for clinical use and clarifying the pathophysiology of NCD have not been achieved.Forty patients undergoing CABG and/or valve procedures using CPB were administered a validated neurocognitive battery preoperatively and postoperatively at day 4 and 3 months. S-100b, neuron specific enolase (NSE), and tau protein were assayed as MBIs preoperatively and postoperatively at 6 hours and day 4. C-reactive protein (CRP), interleukin (IL)-6, C3a, and total peroxide levels were also quantified from serum. Impact of cardiotomy suction and antifibrinolytics on markers of brain injury was assessed.The incidence of early NCD was 40% (16 of 40). NSE and tau protein at the 6-hour time point were both significantly elevated in the presence of NCD (NCD group) compared with those without NCD (NORM group) (8.69 +/- 0.82 vs. 5.98 +/- 0.61; P = 0.018 and 68.8 vs. 29.2%; P = 0.015; respectively). S-100b increase was not different between the NCD and NORM groups. Cardiotomy suction significantly elevated S-100b levels, whereas NSE and tau were not significantly influenced. Aprotinin did not have an effect on NCD or levels of MBIs. Also, the NCD group had significantly elevated CRP and peroxide levels compared with the NORM group at postoperative day 4 while C3a was significantly elevated at 6 hours.NSE and tau are better associated with NCD and less influenced by cardiotomy suction compared with S-100beta. Inflammatory and oxidative stress is associated with NCD post-CPB.Keywords
This publication has 41 references indexed in Scilit:
- Elevated levels of inflammatory biomarkers in the cerebrospinal fluid after coronary artery bypass surgery are predictors of cognitive declineNeurochemistry International, 2006
- Postoperative Cognitive Dysfunction After Cardiac SurgerySocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 2005
- Serum S-100 β Protein During Coronary Artery Bypass Graft Surgery With or Without Cardiopulmonary BypassThe Annals of Thoracic Surgery, 2005
- Brain Injury and Neuropsychological Outcome After Coronary Artery Surgery Are Affected by Complement ActivationThe Annals of Thoracic Surgery, 2005
- Antioxidant defence during cardiopulmonary bypass surgeryEuropean Journal of Cardio-Thoracic Surgery, 2005
- Is there a relationship between serum S-100β protein and neuropsychologic dysfunction after cardiopulmonary bypass?The Journal of Thoracic and Cardiovascular Surgery, 2000
- Do blood levels of neuron‐specific enolase and S‐100 protein reflect cognitive dysfunction after coronary artery bypass?Acta Anaesthesiologica Scandinavica, 1999
- Neuron-specific enolase concentrations in serum and cerebrospinal fluid in patients with no previous history of neurological disorderScandinavian Journal of Clinical and Laboratory Investigation, 1998
- Serial S-100 protein serum measurements related to early magnetic resonance imaging after minor head injuryJournal of Neurosurgery, 1996
- Normothermia Has Beneficial Effects in Cardiopulmonary Bypass Attenuating Inflammatory ReactionsASAIO Journal, 1995