HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Markus K. Heinemann Gerhard Ziemer Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Erb, M. A. Articles by Ziemer, G. Search for Related Content PubMed PubMed Citation Articles by Erb, M. A. Articles by Ziemer, G.

Ann Thorac Surg 2000;69:1515-1519
© 2000 The Society of Thoracic Surgeons

---

Original articles: Cardiovascular

S-100 after correction of congenital heart defects in neonates: is it a reliable marker for cerebral damage?

^a Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Tuebingen University Hospital, Tuebingen, Germany
^b Department of Anesthesiology, Tuebingen University Hospital, Tuebingen, Germany
^c Division of Cardiology, Tuebingen University Hospital, Tuebingen, Germany
^d Division of Neonatology, Department of Pediatrics, Tübingen University Hospital, Tübingen, Germany

Address reprint requests to Dr Erb, Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Tübingen University Hospital, Hoppe Seyler Str 3, D-72076 Tübingen, Germany
e-mail: mike.erb{at}uni-tuebingen.de

Background. Newborns undergoing cardiac operation may acquire some extent of neuronal damage. An early diagnosis is especially hard regarding neonates. In the past years, S-100 has been widely discussed as a marker revealing perioperative damage to the brain.

Methods. Sequential blood samples from 33 neonates undergoing repair of congenital heart disease were taken perioperatively. Samples of 12 healthy neonates were taken at birth as a control group. The newborns were divided into four groups: cyanotic and acyanotic disease operated on in deep hypothermic circulatory arrest, operation without deep hypothermic cardiac arrest, and operation without extracorporeal circulation.

Results. Even in healthy neonates, serum S-100 levels were at 10-fold values compared with adults. On admission, S-100 values in the operative groups were similar. During extracorporeal circulation, levels rose to a certain degree. Cyanotic newborns operated on in deep hypothermic cardiac arrest had significantly higher S-100 levels compared with acyanotic newborns also operated on in deep hypothermic cardiac arrest (p < 0.001). Two newborns who experienced seizures postoperatively had the highest absolute S-100 levels. One child with a poor neurologic outcome but no seizures did not have different values when compared with her group.

Conclusions. In this study, S-100 seemed to be a possible marker for a certain degree of neurologic deficit after cardiac operation in neonates, especially regarding postoperative seizures. The missing peaks of this protein in one newborn with poor neurologic outcome show that it is not possible to exclude damage to the brain with normal postoperative values. These results suggest that the mechanism of cerebral damage and S-100 release into the blood in neonates with a developing central nervous system and blood–brain barrier is not fully understood.

This article has been cited by other articles:

				S. D. Markowitz, R. N. Ichord, G. Wernovsky, J. W. Gaynor, and S. C. Nicolson Surrogate markers for neurological outcome in children after deep hypothermic circulatory arrest. Seminars in Cardiothoracic and Vascular Anesthesia, March 1, 2007; 11(1): 59 - 65. [Abstract] [PDF]

				P. M. Bokesch, E. Appachi, M. Cavaglia, E. Mossad, and R. B.B. Mee A Glial-Derived Protein, S100B, in Neonates and Infants with Congenital Heart Disease: Evidence for Preexisting Neurologic Injury Anesth. Analg., October 1, 2002; 95(4): 889 - 892. [Abstract] [Full Text] [PDF]