S100β after coronary artery surgery: association with lipid peroxidation and neurocognitive scores

MJA Robson¹, RP Alston¹, PJD Andrews ¹ and MJ Souter²

¹Department of Anaesthetics, University of Edinburgh, Edinburgh

²Southern General Hospital, Glasgow, Scotland

from 17th Spring Meeting of the Association of Cardiothoracic Anaesthetists
Cambridge, UK. 14 April 2000

Critical Care 2000, 4(Suppl C):2doi:10.1186/cc704

Published:

12 June 2000

Introduction

Greater levels of S100β after coronary artery bypass grafting (CABG) surgery are thought to indicate cerebral injury [1]. Lipid peroxidation arising from oxidative stress occurs during cardiopulmonary bypass (CPB), and is indicated by increased malondialdehyde concentration [2]. We report the relationships between malondialdehyde production, S100β, and neurological and cognitive scoring 3 months after CABG.

Method

Eighty-six patients aged 60 ± 10 years (mean ± standard deviation) were studied. A structured neurological examination and a battery of cognitive tests were completed the day before and 3 months after surgery by 68 of these patients. A catheter was positioned in the jugular bulb and blood samples were drawn immediately after CPB (post bypass [PBP]) and 6 h after surgery for estimation of S100β and malondialdehyde levels. Lactated Ringer's was used to prime the CPB circuit in the first 21 patients, and subsequent patients received nonlactated prime. Administration of aprotonin was noted. Intervariable relationships was assessed by two-tail Pearson correlation, and stepwise linear regression analysis was used to model malondialdehyde and S100β production.

Results

There was no significant correlation between postsurgical cognitive score and S100β level (r = 0.036; P > 0.1; Table 1).

Table 1.

Conclusion

There is a positive relationship between lipid peroxidation and S100β immediately after CPB. S100β 6 h after surgery is related to neurological score, but not to cognitive score. However, neurological score accounts for only 3% of the variance in S100β, and on the basis of this evidence it can not be recommended as a surrogate marker of subtle neurological outcomes after CABG surgery.

Acknowledgment

Funded by Wellcome Trust Grant 050190.

References

Jonsson H, Johnsson P, Alling C, et al.: Significance of serum S100 release after coronary artery bypass grafting.
Ann Thorac Surg 1998, 65:1639. PubMed Abstract | Publisher Full Text
Abdul-Khaliq H, Blasig IE, Baur MO, et al.: Release of the cerebral protein S-100 into the blood after reperfusion during cardiac operations in infants: Is there a relation to oxygen radical-induced lipid peroxidation?
J Thorac Cardiovasc Surg 1999, 117:1027-1028. PubMed Abstract | Publisher Full Text

This article is part of the supplement: 17th Spring Meeting of the Association of Cardiothoracic Anaesthetists