|Combined Monitoring of rSO2
and SSEP during Cardiopulmonary Bypass and Postoperative Changes
in Plasma Levels of S-100Ŕ: Is Diagnostic Sensitivity for Detecting
Brain Damage Improved?
(First Department of Surgery, Showa University
School of Medicine, Tokyo, Japan)
|Combined monitoring of rSO2
and SSEP is routinely performed during cardiopulmonary bypassiCPB),
but it is not sensitive enough to detect focal lesions of the
brain. Thus, we assessed whether simultaneous measurement of
S-100Ŕ is able to enhance diagnostic sensitivity or not. Between
September 1999 and February 2000, serial measurement of plasma
levels of S-100Ŕ and SSEP and rSO2 monitoring during
CPB were simultaneously performed in 26 consecutive patientsi19
men and 7 women). Ages ranged from 46 to 85imean 67}10years).
Neurological complications developed in 5i19.2%). Among those
patients, hemiplegia developed in 2, and dementia, temporary
convulsion, and deep coma in 1 each. Three of them showed abnormally
low rSO2 levels during surgery, but no patient showed
abnormal change in SSEP waves after surgery. There was no significant
difference in S-100Ŕ level 1 h after CPB between patients associated
with or without neurological complications i1.98}0.48vs. 1.89}1.65j,
however, its level 24 h after CPB remained significantly higher
in patients with neurological complicationsi1.01}1.14vs. 0.22}0.24j.
S-100Ŕ level 24 h after CPB appears to improve diagnostic sensitivity
for detecting such focal brain damage lesions as those in which
SSEP or rSO2 are not efficient enough to make a diagnosis. However,
further study is required to evaluate how fast it can differentiate
patients with and without brain damage.
@Jpn. J. Cardiovasc. Surg. 31F269-273 (2002)