Changes in Cerebral Oxygen Saturation Correlate With S100B in Infants Undergoing Cardiac Surgery With Cardiopulmonary Bypass

Abu‐Sultaneh, Samer; Hehir, David A.; Murkowski, Kathleen; Ghanayem, Nancy S.; Liedel, Jennifer L.; Hoffmann, Raymond G.; Cao, Yumei; Mitchell, Michael E.; Jeromin, Andreas; Tweddell, James S.; Hoffman, George M.

doi:10.1097/pcc.0000000000000055

Cited by 21 publications

(21 citation statements)

References 46 publications

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“…In addition, an increasing number of studies focused on the role of S100β in cognitive function. In previous large-scale investigations, researchers regarded the S100β protein as the marker to evaluate the neurocognitive outcome following cardiac surgery (55,62,63). It is likely that these target genes are important in sevoflurane-induced neurotoxicity.…”

Section: Discussionmentioning

confidence: 99%

Altered hippocampal microRNA expression profiles in neonatal rats caused by sevoflurane anesthesia: MicroRNA profiling and bioinformatics target analysis

Zhang

Wang

et al. 2016

Experimental and Therapeutic Medicine

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Although accumulating evidence has suggested that microRNAs (miRNAs) have a serious impact on cognitive function and are associated with the etiology of several neuropsychiatric disorders, their expression in sevoflurane-induced neurotoxicity in the developing brain has not been characterized. In the present study, the miRNAs expression pattern in neonatal hippocampus samples (24 h after sevoflurane exposure) was investigated and 9 miRNAs were selected, which were associated with brain development and cognition in order to perform a bioinformatic analysis. Previous microfluidic chip assay had detected 29 upregulated and 24 downregulated miRNAs in the neonatal rat hippocampus, of which 7 selected deregulated miRNAs were identified by the quantitative polymerase chain reaction. A total of 85 targets of selected deregulated miRNAs were analyzed using bioinformatics and the main enriched metabolic pathways, mitogen-activated protein kinase and Wnt pathways may have been involved in molecular mechanisms with regard to neuronal cell body, dendrite and synapse. The observations of the present study provided a novel understanding regarding the regulatory mechanism of miRNAs underlying sevoflurane-induced neurotoxicity, therefore benefitting the improvement of the prevention and treatment strategies of volatile anesthetics related neurotoxicity.

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Section: Discussionmentioning

confidence: 99%

Altered hippocampal microRNA expression profiles in neonatal rats caused by sevoflurane anesthesia: MicroRNA profiling and bioinformatics target analysis

Zhang

Wang

et al. 2016

Experimental and Therapeutic Medicine

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“…22,23,[27][28][29] In contrast to previous studies, we defined elevated S100B concentrations to evaluate the impact of cerebral oxygenation and other variables related to surgical treatment and perioperative management on S100B release. 22,23,[27][28][29] In contrast to previous studies, we defined elevated S100B concentrations to evaluate the impact of cerebral oxygenation and other variables related to surgical treatment and perioperative management on S100B release.…”

Section: Discussionmentioning

confidence: 99%

S100B and its relation to cerebral oxygenation in neonates and infants undergoing surgery for congenital heart disease

Hansen

Kissner

Logoteta

et al. 2019

Congenital Heart Disease

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Objectives: Neonates and infants undergoing surgery for congenital heart disease are at risk for developmental impairment. Hypoxic-ischemic brain injury might be one contributing factor. We aimed to investigate the perioperative release of the astrocyte protein S100B and its relation to cerebral oxygenation.Methods: Serum S100B was measured before and 0, 12, 24, and 48 hours after surgery. Cerebral oxygen saturation was derived by near-infrared spectroscopy. S100B reference values based on preoperative samples; concentrations above the 75th percentile were defined as elevated. Patients with elevated S100B at 24 or 48 hours were compared to cases with S100B in the normal range. Neonates (≤28 days) and infants (>28 and ≤365 days) were analyzed separately due to age-dependent release of S100B.Results: Seventy-four patients underwent 94 surgical procedures (neonates, n = 38;infants, n = 56). S100B concentrations were higher in neonates before and after surgery at all time points (P ≤ .015). Highest values were noticed immediately after surgery. Postoperative S100B was elevated after 15 (40.5%) surgeries in neonates.There was no difference in pre-, intra-, or postoperative cerebral oxygenation. In infants, postoperative S100B was elevated after 23 (41.8%) procedures. Preoperative cerebral oxygen saturations tended to be lower (53 ± 12% vs 59 ± 12%, P = .069) and arterial-cerebral oxygen saturation difference was higher (35 ± 11% vs 28 ± 11%, P = .018) in infants with elevated postoperative S100B. In the early postoperative course, cerebral oxygen saturation was lower (54 ± 13% vs 63 ± 12%, P = .011) and arterial-cerebral oxygen saturation difference was wider (38 ± 11% vs 30 ± 10%, P = .008). Cerebral oxygen saturation was also lower for the entire postoperative course (62 ± 18% vs 67 ± 9%, P = .047). Conclusions:Postoperative S100B was elevated in about 40% of neonates and infants undergoing cardiac surgery. Infants with elevated postoperative S100B had impaired perioperative cerebral tissue oxygenation. No relation between S100B and cerebral oxygenation could be demonstrated in neonates. K E Y W O R D Sbrain biomarkers, cardiopulmonary bypass, cerebral protection, near-infrared spectroscopy

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“…Although the kinetics of these molecules in serum remain largely unknown, these data support the hypothesis that the BBB remains permeable in the initial h following CPB but begins to close within the first postoperative day. Abu-Sultaneh et al (48) demonstrated a significant correlation between peak serum S100B following CPB with cerebral oxygen desaturation during surgery, as measured by near-infrared spectroscopy. Furthermore, it has been demonstrated that cerebral oxygen saturation is correlated with neurodevelopmental outcomes and brain MRI at one year of age (58).…”

Section: Discussionmentioning

confidence: 99%

“…The highly phosphorylated form of NF (pNF-H) is resistant to proteolysis and when released from damaged axons remains largely intact; thus, its presence in the blood is indicative of neuronal damage (44,45). Other biomarkers measured included a brain-specific isoform of enolase known as neuron specific enolase (NSE) (46) and S100, a 20 kDa protein belonging to the S100/calmodulin/troponin C superfamily of calcium-binding proteins that forms heterodimers (S100A1B) and homodimers (S100BB) in CNS glial cells and peripheral Schwann cells (47,48). …”

Section: Introductionmentioning

confidence: 99%

Brain injury with systemic inflammation in newborns with congenital heart disease undergoing heart surgery

Pironkova

Giamelli

Seiden

et al. 2017

Experimental and Therapeutic Medicine

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The potential role of systemic inflammation on brain injury in newborns with congenital heart disease (CHD) was assessed by measuring levels of central nervous system (CNS)-derived proteins in serum prior to and following cardiac surgery. A total of 23 newborns (gestational age, 39±1 weeks) with a diagnosis of CHD that required cardiac surgery with cardiopulmonary bypass (CPB) were enrolled in the current study. Serum samples were collected immediately prior to surgery and 2, 24 and 48 h following CPB, and serum levels of phosphorylated neurofilament-heavy subunit (pNF-H), neuron-specific enolase (NSE) and S100B were analyzed. Systemic inflammation was assessed by measuring serum concentrations of complement C5a and complement sC5b9, and the following cytokines: Interleukin (IL)-1β, IL-6, IL-8, IL-10, IL12p70, interferon γ and tumor necrosis factor (TNF)-α. Analysis of cord blood from normal term deliveries (n=26) provided surrogate normative values for newborns. pNF-H and S100B were 2.4- to 2.8-fold higher (P<0.0001) in patient sera than in cord blood prior to surgery and remained elevated following CPB. Pre-surgical serum pNF-H and S100B levels directly correlated with interleukin (IL)-12p70 (ρ=0.442, P<0.05). pNF-H was inversely correlated with arterial pO2 prior to surgery (ρ=−0.493, P=0.01) and directly correlated with arterial pCO2 post-CPB (ρ=0.426, P<0.05), suggesting that tissue hypoxia and inflammation contribute to blood brain barrier (BBB) dysfunction and neuronal injury. Serum IL12p70, IL-6, IL-8, IL-10 and TNF-α levels were significantly higher in patients than in normal cord blood and levels of these cytokines increased following CPB (P<0.001). Activation of complement was observed in all patients prior to surgery, and serum C5a and sC5b9 remained elevated up to 48 h post-surgery. Furthermore, they were correlated (P<0.05) with low arterial pO2, high pCO2 and elevated arterial pressure in the postoperative period. Length of mechanical ventilation was associated directly with post-surgery serum IL-12p70 and IL-8 concentrations (P<0.05). Elevated serum concentrations of pNF-H and S100B in neonates with CHD suggest BBB dysfunction and CNS injury, with concurrent hypoxemia and an activated inflammatory response potentiating this effect.

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Changes in Cerebral Oxygen Saturation Correlate With S100B in Infants Undergoing Cardiac Surgery With Cardiopulmonary Bypass

Abstract: A wide cerebral arteriovenous difference measured by near-infrared spectroscopy during cardiopulmonary bypass is associated with increased serum S100B in the perioperative period and may be a modifiable risk factor for neurological injury.

Cited by 21 publications

References 46 publications

Altered hippocampal microRNA expression profiles in neonatal rats caused by sevoflurane anesthesia: MicroRNA profiling and bioinformatics target analysis

Altered hippocampal microRNA expression profiles in neonatal rats caused by sevoflurane anesthesia: MicroRNA profiling and bioinformatics target analysis

S100B and its relation to cerebral oxygenation in neonates and infants undergoing surgery for congenital heart disease

Brain injury with systemic inflammation in newborns with congenital heart disease undergoing heart surgery

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