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Hashim Abdul-Khaliq, Stephan Schubert, Thomas Thomas Fischer, Wolfgang Böttcher, Cornelia Harke, Vladimir Alexi-Meskishvili, Peter E. Lange, Ingolf E. Blasig
The Effect of Continuous Treatment with Sodium Nitroprusside on the Serum Kinetics of the Brain Marker Protein S-100? in Neonates Undergoing Corrective Cardiac Surgery by Means of Hypothermic Cardiopulmonary Bypass
Neonates who undergo cardiac surgery of d-transposition
of the great arteries by means of hypothermic cardiopulmonary
bypass (CPB) represent a group at increased
risk to develop brain injury and altered
psychomotor development in early life. Measurement
of protein S-100?, an astrocytic calcium binding protein,
in serum may provide information on transient
astroglial cell activation and disintegration of the related
blood-brain barrier due to oxidative stress during
and after CPB. Conflicting results have been reported
that concern the neuroprotective effect of the NO liberator
sodium nitroprusside (SNP)
The data on 25 neonates treated intraoperatively and postoperatively and 28 without treatment were analyzed. SNP was infused (1–5 ?g/kg body weight/minute depending on the haemodynamic status) after the induction of anesthesia, and during and after the termination of CPB for 2 days. Serum concentrations of S-100? were analyzed by the use of a commercially available immunoluminometric kit (Byk-Sangtec®, Dietzenbach, Germany).
There were no significant differences in the bypass data between the SNP-treated and non-treated group. In comparison to the pre-bypass values, a similar increase in the concentration of protein S-100? was found 2 hours after the termination of CPB in the SNPtreated and non-treated neonates, which decreased over the subsequent 48 postoperative hours. However, significantly lower post-bypass serum levels of S-100? were found in the SNP-treated group after 24 hours (p = 0.0009) and 48 hours (p = 0.04) of treatment.
In conclusion, the significant elevation of serum levels of protein S-100? may indicate increased astroglial cell reactivity and increased passage into the blood stream. Longer-lasting treatment with NO liberator SNP seemed to decrease the release of S-100? into the blood stream and may have delayed protection on the astroglial cells. The neurological significance of such an observation, however, should be evaluated in further follow-up studies, which need to include additional neurophysiological and neurodevelopmental tests.
Clinical Chemical Laboratory Medicine, Walter de Gruyter
Print ISSN: 1434-6621
Volume: 38, 11/2000
Pages: 1173 - 1175