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Serum S100B levels in patients after cardiac surgery: possible sources of contamination.

机译:心脏手术后患者的血清S100B水平:可能的污染源。

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BACKGROUND: S100B protein is considered to be a potential marker of brain damage. The aim of our study was to determine the contamination effect of retransfused blood on the serum S100B concentrations in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) and to differentiate between this simple contamination effect and its possible enhancement by haemolysis. METHODS: The first part of the study was performed in a group of 10 patients scheduled for coronary artery bypass grafting. Baseline S100B level was determined in a blood sample drawn from the radial artery before skin incision. After performing the distal anastomosis, additional blood samples were drawn from 1) the radial artery, 2) the aortic root catheter, 3) the pericardial space, and 4) CPB suction. To study the possible haemolytic effect on serum S100B levels, a second group of 23 patients was studied. S100B concentrations were determined in samples drawn simultaneously from the radial artery and bypass circuit after the end of CPB. Further samples from the retransfusion blood bag were analysed after one, two and three hours. RESULTS: Blood samples from the pericardial space and CPB suction exhibited significantly higher levels of S100B than the samples drawn from the peripheral artery and aortic root catheter in the first group of patients. No significant differences between the S100B levels in the peripheral blood and aortic root catheter were detected. In the second group, S100B was significantly elevated in the samples taken from the retransfusion blood bag in comparison with peripheral blood. S100B levels remained stable during the whole follow-up period. CONCLUSION: The results of our study show increased serum S100B levels caused by contamination originating in the mediastinal tissues. Storage of blood in the retransfusion bag and haemolysis can be excluded as sources of contamination. The role of S100B in perioperative monitoring of patients undergoing cardiac surgery remains to be established and should be confirmed by further studies using neuropsychological tests and imaging techniques.
机译:背景:S100B蛋白被认为是脑损伤的潜在标志。我们研究的目的是确定在进行了体外循环(CPB)心脏手术的患者中,重新输血对血清S100B浓度的污染作用,并区分这种简单的污染作用和可能的溶血作用。方法:本研究的第一部分是在10例计划进行冠状动脉搭桥术的患者中进行的。在皮肤切开之前从the动脉抽取的血液样本中确定基线S100B水平。进行远端吻合后,从1)radial动脉,2)主动脉根导管,3)心包间隙和4)CPB抽吸中抽取其他血液样本。为了研究可能对血清S100B水平的溶血作用,研究了第二组23例患者。在CPB结束后,同时从the动脉和旁路回路抽取的样品中确定S100B浓度。一小时,两小时和三小时后,对来自输血血袋的其他样本进行了分析。结果:在第一组患者中,来自心包间隙和CPB抽吸的血液样本显示出的S100B水平明显高于从外周动脉和主动脉根导管抽取的样本。在外周血和主动脉根导管中的S100B水平之间未检测到显着差异。在第二组中,与外周血相比,从回输血袋中采集的样品中S100B显着升高。在整个随访期间,S100B水平保持稳定。结论:我们的研究结果表明,由于纵隔组织污染引起的血清S100B水平升高。再输血袋中的血液存储和溶血可以作为污染源排除在外。 S100B在心脏手术患者围手术期监测中的作用尚待确定,应通过使用神经心理学测试和成像技术的进一步研究予以证实。

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