Combined Monitoring of rSO2 and SSEP during Cardiopulmonary Bypass and Postoperative Changes in Plasma Levels of S-100.BETA.: Is Diagnostic Sensitivity for Detecting Brain Damage Improved?
10.4326/jjcvs.31.269
- VernacularTitle:体外循環中における脳組織内酸素飽和度（ｒＳＯ２），短潜時体性感覚誘発電位（ＳＳＥＰ）の同時測定および血中Ｓ‐１００βの変動について 術後脳合併症診断の感度向上に有用か？
- Author:
Hiroshi Ohtake
;
Atsuyoshi Oki
;
Yoshiharu Okada
;
Masahiro Aiba
;
Tadanori Kawada
;
Toshihiro Takaba
- Publication Type:Journal Article
- Keywords:
S-100β
- From:Japanese Journal of Cardiovascular Surgery
2002;31(4):269-273
- CountryJapan
- Language:Japanese
-
Abstract:
Combined monitoring of rSO2 and SSEP is routinely performed during cardiopulmonary bypass (CPB), but it is not sensitive enough to detect focal lesions of the brain. Thus, we assessed whether simultaneous measurement of S-100β is able to enhance diagnostic sensitivity or not. Between September 1999 and February 2000, serial measurement of plasma levels of S-100β and SSEP and rSO2 monitoring during CPB were simultaneously performed in 26 consecutive patients (19 men and 7 women). Ages ranged from 46 to 85 (mean 67±10 years). Neurological complications developed in 5 (19.2%). 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-100β level 1h after CPB between patients associated with or without neurological complications (1.98±0.48 vs. 1.89±1.65), however, its level 24h after CPB remained significantly higher in patients with neurological complications (1.01±1.14 vs. 0.22±0.24). S-100β level 24h 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.
