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Stephen Westaby
Per Johnsson
Andrew J. Parry
Ravi Pillai
David P. Taggart
Erik Ståhl
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Ann Thorac Surg 1996;61:88-92
© 1996 The Society of Thoracic Surgeons

Original Articles: Cardiovascular

Serum S100 Protein: A Potential Marker for Cerebral Events During Cardiopulmonary Bypass

Stephen Westaby, FRCS, Per Johnsson, MD, PhD, Andrew J. Parry, FRCS, Sten Blomqvist, MD, PhD, Jan-Otto Solem, MD, PhD, Christer Alling, MD, PhD, Ravi Pillai, FRCS, David P. Taggart, MD (Hons), Catherine Grebenik, MD, Erik Ståhl, MD, PhD

Oxford Heart Centre, Oxford, England, and Departments of Cardiothoracic Surgery, Anaesthesia, Psychiatry, and Neurochemistry, University Hospital of Lund, Lund, Sweden

Accepted for publication August 14, 1995.

Background. There is no simple method to determine the incidence or severity of brain injury after a cardiac operation. A serum marker equivalent to cardiac enzymes is required. S100 protein leaks from the cerebrospinal fluid to blood after cerebral injury. We sought to determine the pattern of release after extracorporeal circulation (ECC).

Methods. Thirty-four patients without neurologic problems underwent coronary bypass using ECC. Four had carotid stenoses. Nine others underwent coronary bypass without ECC. Serum S100 levels were measured before, during, and after the operation.

Results. S100 was not detected before sternotomy. Postoperative levels of S100 were related to duration of perfusion (r = 0.89, p < 0.001). Patients who did not have ECC had undetectable or fractionally raised levels except in 1 who suffered a stroke. No patient in whom ECC was used suffered an event, but those with carotid stenoses had greater S100 levels.

Conclusions. S100 protein leaks into blood during ECC and may reflect both cerebral injury and increased permeability of the blood brain barrier. S100 is a promising marker for cerebral injury in cardiac surgery if elevated levels can be linked with clinical outcome.


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