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Haci Akar
Hasan Tahsin Keceligil
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Ann Thorac Surg 2005;79:666-671
© 2005 The Society of Thoracic Surgeons

Original article: Cardiovascular

Comparison of Hydroxyethyl Starch and Ringer Lactate as a Prime Solution Regarding S-100ß Protein Levels and Informative Cognitive Tests in Cerebral Injury

Erkan Iriz, MDa,*, Fersat Kolbakir, MDb, Haci Akar, MDc, Bahattin Adam, MDd, Hasan Tahsin Keceligil, MDb

a Department of Cardiovascular Surgery, School of Medicine, Gazi University, Ankara, Turkey
b Department of Cardiovascular Surgery, School of Medicine, Ondokuz Mayis University, Samsun, Turkey
c Department of Cardiovascular Surgery, State Hospital of Samsun, Samsun, Turkey
d Department of Biochemistry, School of Medicine, Fatih University, Ankara, Turkey

Accepted for publication August 4, 2004.

* Address reprint requests to Dr Iriz, Gazi University Tip Fakültesi Kalp ve Damar Cerrahisi AD Besevler, Ankara 06500, Turkey (E-mail: erkaniriz{at}hotmail.com).

BACKGROUND: Cognitive dysfunction (as an indicator of cerebral dysfunction after open heart surgery) was observed in as many as 70% of patients who underwent cardiopulmonary bypass. S-100ß protein is a sensitive indicator of cerebral injury. We aimed to compare the effects of hydroxyethyl starch and Ringer lactate prime solutions in the protection of cerebral tissue in cardiopulmonary bypass using serum S-100ß protein levels and informative cognitive tests.

METHODS: Patients were randomized into two groups. Open heart surgery was performed by using hydroxyethyl starch solution in group 1 (n = 15) and Ringer lactate solution in group 2 (n = 15). Preoperative, perioperative, and postoperative S-100ß protein levels and informative cognitive test scores, clinical and operational characteristics of the patients were compared.

RESULTS: A significant difference was found only between preoperative and postoperative results of verbal accuracy (human) test in group 1, whereas differences between preoperative and postoperative scores of continuous skill, verbal accuracy (human), verbal accuracy (animal), verbal accuracy (human–animal), go-no-go paradigm, calculation, and abstract thinking tests were significant in group 2 (p ≤ 0.05). The S-100ß protein levels were not significantly different between the groups (group p = 0.97).

CONCLUSIONS: Because hydroxyethyl starch prime solution used in extracorporeal circulation had significant positive effects with informative–cognitive tests when compared to Ringer lactate solution, it seems to be a better prime solution to prevent cerebral dysfunction in these patients.






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