Neurone-specific enolase and Sangtec 100 assays during cardiac surgery: part III - does haemolysis affect their accuracy?

Perfusion ◽  
1997 ◽  
Vol 12 (3) ◽  
pp. 171-177 ◽  
Author(s):  
F Gao ◽  
D N F Harris ◽  
S Sapsed-Byrne ◽  
S Sharp
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Neuronal Damage ◽  
Red Cells ◽  
Cerebral Damage ◽  
Correction Formula ◽  
S 100 ◽  
Serial Dilutions

Neurone-specific enolase (NSE) and Sangtec 100 (S-100) are useful for detecting cerebral damage during cardiopulmonary bypass (CPB). However, red cells contain NSE, and the haemolysis frequently caused by CPB could produce a false rise in NSE; S-100 is not found in red cells and should not be affected. We, therefore, compared the effects of haemolysis on NSE and S-100 to see if correction was necessary and possible. From seven patients, serial dilutions of haemolysed red cells were added to plasma (1/64-1/2048), measured for absorption at 540 nm and assayed for NSE and S-100. S-100 concentrations showed no change with haemolysis. Measured NSE increased significantly with haemolysis >1/512 (an increase of 6.6 μg/ml): a correction formula is presented. In 39/48 patients after CPB, mean haemolysis was <1/256 and would not need any correction. NSE and S-100 assay can, therefore, be used throughout CPB, which allows both glial and neuronal damage to be studied.

Neurone-specific enolase and Sangtec 100 assays during cardiac surgery: part II - must samples be spun within 30 min?

Perfusion ◽  
1997 ◽  
Vol 12 (3) ◽  
pp. 167-169 ◽  
Author(s):  
S Sapsed-Byrne ◽  
F Gao ◽  
D N F Harris
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Plasma Levels ◽  
Room Temperature ◽  
Cerebral Damage ◽  
Blood Samples ◽  
Before And After ◽  
S 100

Sangtec 100 (S-100) (Sangtec Medical, Sweden) and neurone-specific enolase (NSE) assays are showing promise in the assessment of cerebral damage following cardiopulmonary bypass (CBP). The manufacturer’s instructions state, however, that samples must be spun and frozen within 30 min, which is inconvenient for serial studies. We, therefore, investigated whether storing blood samples at room temperature (RT) or 4°C for up to 48 h affected the measured levels. Blood samples were taken before and after CBP in six patients and stored for 15 min, 4, 8, 24 or 48 h at RT or 4°C. S-100 and NSE levels did not alter in either ‘before surgery’ or CPB samples when stored for up to 48 h at 4°C. There was a small, nonsignificant rise when stored at RT. Samples may, therefore, be collected throughout long operations or stored overnight without affecting NSE or S-100 plasma levels.

Neurone-specific enolase and Sangtec 100 assays during cardiac surgery: part I - the effects of heparin, protamine and propofol

Perfusion ◽  
1997 ◽  
Vol 12 (3) ◽  
pp. 163-165 ◽  
Author(s):  
F Gao ◽  
D NF Harris ◽  
S Sapsed-Byrne ◽  
S Sharp
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Normal Saline ◽  
Lipid Emulsion ◽  
Cerebral Damage ◽  
Blood Samples ◽  
S 100 ◽  
Group A ◽  
Group B ◽  
Group D

Neurone-specific enolase (NSE) and Sangtec 100 (S-100) (Sangtec Medical, Sweden) assays are designed for clotted samples, but when studying cerebral damage following cardiac surgery, perioperative samples will contain heparin and/or protamine. The lipid emulsion propofol is also frequently used during cardiac surgery and could affect the assays. We, therefore, studied the effects of heparin, protamine and propofol on the accuracy of NSE and S-100 assays in five healthy patients. Blood samples were taken and divided into four groups: normal saline was added to group A; heparin to group B; heparin followed by protamine to group C; and propofol to group D. NSE and S-100 concentrations were measured for all samples. Neither heparin, protamine nor propofol affected the accuracy of S-100 and NSE assays; therefore, samples can be taken throughout operations involving cardiopulmonary bypass without influencing the results.

scholarly journals Molecular signatures of neurotoxicity in cardiac surgery with cardiopulmonary bypass

Stroke ◽  
2001 ◽  
Vol 32 (suppl_1) ◽  
pp. 341-341
Author(s):  
Jose Castillo ◽  
Vicente Ginesta ◽  
Valentin Rodriguez ◽  
Joaquin Serena ◽  
Rogelio Leira ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Neuronal Damage ◽  
Cross Clamp Time ◽  
Tnf Α ◽  
Prior Surgery ◽  
Perfusion Time ◽  
Underlying Mechanisms ◽  
Lower Temperature ◽  
Inhibitory Amino Acids

P12 Background Neurobehavioral disorders, and stroke are frequently reported after cardiac surgery. Although cerebral neuronal damage may be caused by transient or outlasting hypoxia as a consequence of embolism, the underlying mechanisms remain unsettled. Objective: To analyze changes in the biochemical markers of neurotoxicity in 26 patients who underwent CABG (n=14), valve replacement (n=10) or other cardiac surgery (n=2) with cardiopulmonary bypass (CPB). Methods: The surgical protocol recorded the total perfusion time, cross-clamp time, minimum nasopharyngeal temperature and mean arterial pressure (MAP). Canadian stroke scale was evaluated prior surgery, at 24h and 48h after CPB. Blood samples were obtained immediately before surgery, just after surgery, at 6h, and at 24h after CPB. Mean perfusion time was 105±36 min, mean cross-clamp time was 67±27 min, and mean lower temperature was 30.6±1.7°C. MAP was lower than 50 mmHg in 4 patients, and remained between 50 and 90 mmHg in 22. Results: Glutamate concentrations increased four fold, and L-arginine and GABA levels decreased 30%, just after surgery (all p<0.001). Amino acid concentrations returned to normal values at 24h. Glutamate, L-arginine and GABA levels after surgery correlated with the cross-clamp time (r=0.86, r=-0.69, and r=-0.56, respectively) (all p<0.01), but not with the lower body temperature during intervention. Glutamate levels were higher in patients with MAP<50mmHg (p=0.022). The highest glutamate concentration was observed in a patient who developed a cerebral infarct. No significant changes were found in proinflammatory parameters in blood (IL-6, TNF-α, ICAM-1 and VCAM-1). Conclusions: CPB is associated with an important increase of excitatory, and decrease of inhibitory amino acids in the blood. L-arginine consumption might reflect nitric oxide generation. These findings suggest that cerebral excitotoxicity may occur in cardiac surgery. Prophylactic neuroprotection in CPB should be investigated in clinical trials.

S-100 protein during cardiac surgery: comparison of cardiopulmonary bypass circuits

2001 ◽  
Vol 18 (Supplement 22) ◽  
pp. 21-22
Author(s):  
E. Bernoud ◽  
P. Ménestret ◽  
T. Langanay ◽  
V. Quillien ◽  
A. Leguerrier ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
S 100

S-100 Protein and Neuron-Specific Enolase as Markers of Subclinical Cerebral Damage after Cardiac Surgery: Preliminary Observation of a 6-Month Follow-Up Study

2001 ◽  
Vol 45 (3) ◽  
pp. 151-159 ◽  
Author(s):  
Anna Maria Basile ◽  
Costanza Fusi ◽  
Andrea Alberto Conti ◽  
Rita Paniccia ◽  
Gloria Trefoloni ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Neuron Specific Enolase ◽  
Preliminary Observation ◽  
Cerebral Damage ◽  
Follow Up Study ◽  
S 100

Increased levels of S-100 protein after cardiac surgery with cardiopulmonary bypass and general surgery in children

2000 ◽  
Vol 10 (3) ◽  
pp. 297-302 ◽  
Author(s):  
Eva Jensen ◽  
Kerstin Sandström ◽  
Svenerik Andréasson ◽  
Krister Nilsson ◽  
HÃ¥kan Berggren ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
General Surgery ◽  
S 100

scholarly journals Postoperative delirium in children in undergoing treatment of congenital septal heart defects

2021 ◽  
Vol 18 (2) ◽  
pp. 62-68
Author(s):  
A. A. Ivkin ◽  
E V. Grigoriev ◽  
A. V. Tsepokina ◽  
D. L. Shukevich
Keyword(s):  
Cardiopulmonary Bypass ◽  
Postoperative Period ◽  
Postoperative Delirium ◽  
Heart Defects ◽  
Neuron Specific Enolase ◽  
Protein S ◽  
Congenital Defects ◽  
Cerebral Damage ◽  
Surgical Interventions ◽  
S 100

The objective: to establish the prevalence of postoperative delirium (POD) and the influence of various factors in intra- and postoperative periods on its occurrence in children with septal congenital defects requiring surgical interventions with cardiopulmonary bypass (CPB).Subjects and methods: 40 children from 6 to 36 months and weighing from 7.5 to 15 kg were enrolled in the study; they underwent planned radical surgery of septal CHD with cardiopulmonary bypass. In the postoperative period, all patients were tested using the Cornell Assessment for Pediatric Delirium validated for children of this age. Cerebral damage was also assessed using three specific serum markers: protein S-100-ß, neuron-specific enolase (NSE) and glial fibrillar acidic protein (GFAP) before the surgery, upon bypass completion, and in 16 hours after the operation.Results. The study revealed the incidence of delirium in 22.5%. When analyzing many factors of the intra- and postoperative period, it was found that the use of donor blood components in the primary volume of CPB filling was statistically significantly more often observed in patients with established delirium: 7 (78%) and 13 (42%) (p = 0.049). Also, it was found that levels of S-100-ß, NSE, and GFAP were significantly higher in patients with confirmed POD.The study described the incidence of POD in children after surgical treatment of congenital heart disease under cardiopulmonary bypass and showed that intraoperative transfusion was a risk factor for the development of delirium. The role of markers of cerebral damage in the diagnosis of POD was also proven.

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