Title:Predictors of Ominous Outcome in Infants who Undergo Cardiac Surgery and Cardiopulmonary By-Pass: S100B Protein
Volume: 14
Issue: 1
Author(s): Alessandro Varrica, Angela Satriano, Guido Tettamanti, Gabriele Pelissero, Antonio D.W. Gavilanes, Luc J. Zimmermann, Hans J.S. Vles, Pasquale Florio, Francesca R. Pluchinotta and Diego Gazzolo
Affiliation:
Keywords:
Brain damage, congenital heart diseases, CPB, S100B protein.
Abstract: S100B protein has been recently proposed as a consolidated marker of brain damage
and death in adult, children and newborn patients. The present study evaluates whether the
longitudinal measurement of S100B at different perioperative time-points may be a useful tool
to identify the occurrence of perioperative early death in congenital heart disease (CHD)
newborns.
We conducted a case-control study in 88 CHD infants, without pre-existing neurological
disorders or other co-morbidities, of whom 22 were complicated by perioperative death in the
first week from surgery. Control group was composed by 66 uncomplicated CHD infants
matched for age at surgical procedure. Blood samples were drawn at five predetermined timepoints
before during and after surgery.
In all CHD children, S100B levels showed a pattern characterized by a significant increase in protein’s concentration from
hospital admission up to 24-h after procedure reaching their maximum peak (P<0.01) during cardiopulmonary by-pass
and at the end of the surgical procedure. Moreover, S100B concentrations in CHD death group were significantly higher
(P<0.01) than controls at all monitoring time-points. The ROC curve analysis showed that S100B measured before
surgical procedure was the best predictor of perioperative death, among a series of clinical and laboratory parameters,
reaching at a cut-off of 0.1 µg/L a sensitivity of 100% and a specificity of 63.7%.
The present data suggest that in CHD infants biochemical monitoring in the perioperative period is becoming possible and
S100B can be included among a series of parameters for adverse outcome prediction.
