Phentolamine administration increases blood S100B protein levels in pediatric open-heart surgery patients

Gazzolo, Diego; Masetti, P; Kornacka, M; Abella, R; Bruschettini, P; Michetti, F

doi:10.1080/08035250310006566

Cited by 5 publications

(10 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…From one hand, the absence of any interference in circulating S100B in the perioperative period is in agreement with previous observations, both in adults and children, reporting no compromise on the diagnostic value of S100B in neurological diseases in intact subjects (without traumatic brain or bodily injury from accident or surgery) [ 26 ]. These findings are also consistent with the usefulness of the protein in brain monitoring of CHD infants [ 18 – 20 ]. On the other hand, the discrepancy with previous observations warrants further consideration in terms of contamination following invasive procedures during CPB.…”

Section: Discussionsupporting

confidence: 88%

“…S100B is an acidic calcium-modulated protein of low molecular weight, first identified by Moore as a protein fraction detectable in the central nervous system (CNS) in glial and Schwann cells and in specific neuronal subpopulations [ 16 ]. With regard to CHD infants who underwent cardiac surgery and CPB, S100B has been shown to be increased in the perioperative period [ 17 , 18 ], to correlate with different CPB phases [ 19 ] and with increased cerebrovascular resistance and brain damage [ 20 ]. However, protein's assessment in CHD infants for CPB monitoring has been progressively abandoned on the basis of S100B extra CNS site of concentrations including adipose tissue [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Circulating S100B and Adiponectin in Children Who Underwent Open Heart Surgery and Cardiopulmonary Bypass

Varrica

Satriano

Frigiola

et al. 2015

BioMed Research International

View full text Add to dashboard Cite

Background. S100B protein, previously proposed as a consolidated marker of brain damage in congenital heart disease (CHD) newborns who underwent cardiac surgery and cardiopulmonary bypass (CPB), has been progressively abandoned due to S100B CNS extra-source such as adipose tissue. The present study investigated CHD newborns, if adipose tissue contributes significantly to S100B serum levels. Methods. We conducted a prospective study in 26 CHD infants, without preexisting neurological disorders, who underwent cardiac surgery and CPB in whom blood samples for S100B and adiponectin (ADN) measurement were drawn at five perioperative time-points. Results. S100B showed a significant increase from hospital admission up to 24 h after procedure reaching its maximum peak (P < 0.01) during CPB and at the end of the surgical procedure. Moreover, ADN showed a flat pattern and no significant differences (P > 0.05) have been found all along perioperative monitoring. ADN/S100B ratio pattern was identical to S100B alone with the higher peak at the end of CPB and remained higher up to 24 h from surgery. Conclusions. The present study provides evidence that, in CHD infants, S100B protein is not affected by an extra-source adipose tissue release as suggested by no changes in circulating ADN concentrations.

show abstract

Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Circulating S100B and Adiponectin in Children Who Underwent Open Heart Surgery and Cardiopulmonary Bypass

Varrica

Satriano

Frigiola

et al. 2015

BioMed Research International

View full text Add to dashboard Cite

show abstract

“…6) Intervene: Patients with utilizations of modified CPB circuit and oxygenators [ 25 , 26 , 60 , 72 ] , cell saving reservoir [ 33 ] , anesthetic agents and priming components (propofol [ 53 ] , isoflurane [ 64 ] , hydroxyethyl [ 46 ] and starch [ 42 ] ) during the operation aiming at lessening the cerebral damage were defined as the Intervene Subgroup. Those without intervenes were defined as control.…”

Section: Methodsmentioning

confidence: 99%

S100 and S100β: biomarkers of cerebral damage in cardiac surgery with or without the use of cardiopulmonary bypass

Yuan¹

2014

Revista Brasileira De Cirurgia Cardiovascular

View full text Add to dashboard Cite

ObjectiveThe present study is to describe the clinical impact of S100 and S100β for the evaluation of cerebral damage in cardiac surgery with or without the use of cardiopulmonary bypass (CPB).MethodsQuantitative results of S100 and S100β reported in the literature of the year range 1990-2014 were collected, screened and analyzed.ResultsCerebrospinal fluid and serum S100 levels showed a same trend reaching a peak at the end of CPB. The cerebrospinal fluid/serum S100 ratio decreased during CPB, reached a nadir at 6 h after CPB and then increased and kept high untill 24 h after CPB. Serum S100 at the end of CPB was much higher in infant than in adults, and in on-pump than in off-pump coronary artery bypass patients. ∆S100 increased with age and CPB time but lack of statistical significances. Patients receiving an aorta replacement had a much higher ∆S100 than those receiving a congenital heart defect repair. Serum S100β reached a peak at the end of CPB, whereas cerebrospinal fluid S100 continued to increase and reached a peak at 6 h after CPB. The cerebrospinal fluid/serum S100β ratio decreased during CPB, increased at the end of CPB, peaked 1 h after CPB, and then decreased abruptly. The increase of serum S100β at the end of CPB was associated with type of operation, younger age, lower core temperature and cerebral damages. ∆S100β displayed a decreasing trend with age, type of operation, shortening of CPB duration, increasing core temperature, lessening severity of cerebral damage and the application of intervenes. Linear correlation analysis revealed that serum S100β concentration at the end of CPB correlated closely with CPB duration.ConclusionS100 and S100β in cerebrospinal fluid can be more accurate than in the serum for the evaluations of cerebral damage in cardiac surgery. However, cerebrospinal fluid biopsies are limited. But serum S100β and ∆S100β seem to be more sensitive than serum S100 and ∆S100. The cerebral damage in cardiac surgery might be associated with younger age, lower core temperature and longer CPB duration during the operation. Effective intervenes with modified CPB circuit filters or oxygenators and supplemented anesthetic agents or priming components may alleviate the cerebral damage.

show abstract

“…The overall methodological quality of the included studies was analyzed with the Cochrane Risk of Bias Tool ( 23 , 24 ) There were 2 studies of high ( 26 , 27 ) (EPO, allopurinol) , 2 studies of moderate ( 28 , 29 ) (ketamine, dextromethorpan) and 2 studies of low ( 30 , 31 ) (SNP, phentolamine) methodological quality (Table 2 , Figure 2 ).…”

Section: Resultsmentioning

confidence: 99%

Neuroprotective Drugs in Infants With Severe Congenital Heart Disease: A Systematic Review

et al. 2018

View full text Add to dashboard Cite

Background: Perinatal and perioperative brain injury is a fundamental problem in infants with severe congenital heart disease undergoing neonatal cardiac surgery with cardiopulmonary bypass. An impaired neuromotor and neurocognitive development is encountered and associated with a reduction in quality of life. New neuroprotective drugs during surgery are described to reduce brain injury and improve neurodevelopmental outcome. Therefore, our aim was to provide a systematic review and best-evidence synthesis on the effects of neuroprotective drugs on brain injury and neurodevelopmental outcome in congenital heart disease infants requiring cardiac surgery with cardiopulmonary bypass.Methods: A systematic search was performed in PubMed, Embase and the Cochrane Library (PRISMA statement). Search terms were “infants,” “congenital heart disease,” “cardiac surgery,” “cardiopulmonary bypass,” and “neuroprotective drug.” Data describing the effects on brain injury and neurodevelopmental outcome were extracted. Study quality was assessed with the Cochrane Risk of Bias Tool. Two reviewers independently screened sources, extracted data and scored bias. Disagreements were resolved by involving a third researcher.Results: The search identified 293 studies of which 6 were included. In total 527 patients with various congenital heart diseases participated with an average of 88 infants (13–318) per study. Allopurinol, sodium nitroprusside, erythropoietin, ketamine, dextromethorphan and phentolamine were administered around cardiac surgery with cardiopulmonary bypass. Allopurinol showed less seizures, coma, death and cardiac events in hypoplastic left heart syndrome (HLHS) infants (OR: 0.44; 95%-CI:0.21–0.91). Sodium nitroprusside resulted in lower post cardiopulmonary bypass levels of S100ß in infants with transposition of the great arteries after 24 (p < 0.01) and 48 (p = 0.04) h of treatment. Erytropoietin, ketamine and dextromethorphan showed no neuroprotective effects. Phentolamine led to higher S100ß-levels and cerebrovascular resistance after rewarming and at the end of surgery (both p < 0.01). Risk of bias varied between studies, including low (sodium nitroprusside, phentolamine), moderate (ketamine, dextromethorphan), and high (erytropoietin, allopurinol) quality.Conclusions: Allopurinol seems promising for future trials in congenital heart disease infants to reduce brain injury given the early neuroprotective effects in hypoplastic left heart syndrome infants. Larger well-designed trials are needed to assess the neuroprotective effects of sodium nitroprusside, erytropoietin, ketamine and dextromethorphan. Future neuroprotective studies in congenital heart disease infants should not only focus on the perioperative period, however also on the perinatal period, since significant brain injury already exists before surgery.

show abstract

Phentolamine administration increases blood S100B protein levels in pediatric open-heart surgery patients

Abstract: Despite improved peripheral vasodilatation and perfusion, phentolamine administration in pediatric open-heart surgery is correlated with increased cerebrovascular resistance and brain damage.

Cited by 5 publications

References 26 publications

Circulating S100B and Adiponectin in Children Who Underwent Open Heart Surgery and Cardiopulmonary Bypass

Circulating S100B and Adiponectin in Children Who Underwent Open Heart Surgery and Cardiopulmonary Bypass

S100 and S100β: biomarkers of cerebral damage in cardiac surgery with or without the use of cardiopulmonary bypass

Neuroprotective Drugs in Infants With Severe Congenital Heart Disease: A Systematic Review

Contact Info

Product

Resources

About