Shaaban Ali M, Harmer M, Vaughan R S, Dunne J, Latto I P
Department of Anaesthetics and Intensive Care Medicine, University of Wales College of Medicine, Heath Park, Cardiff CF14 4XN, UK.
Anaesthesia. 2000 Aug;55(8):802-6. doi: 10.1046/j.1365-2044.2000.01330-1.x.
Warm blood cardioplegia may be more beneficial to the heart than cold cardioplegia, but the effects of warm cardiopulmonary bypass and warm blood cardioplegia on the brain are controversial. S100 protein is an early marker of brain damage and has been detected after cold cardiopulmonary bypass. We studied S100 concentrations in 20 patients undergoing coronary artery bypass surgery before and after warm cardiopulmonary bypass (34-37 degrees C) using warm blood cardioplegia (37 degrees C) for all patients. The peak level of S100 protein occurred immediately after warm cardiopulmonary bypass, then decreased progressively until the last measurement at 4.5 h after bypass. The peak level appears to be dependent upon the age of the patient, with the following regression equation: y = -3.2 + 0.08x, where y is S100 protein concentration in microg.l-1 and x is patient age in years. Further studies are needed to investigate the clinical significance of this early release pattern. Patient age should be taken into account when studying S100 protein levels after cardiopulmonary bypass.
温血心脏停搏液可能比冷血心脏停搏液对心脏更有益,但温体外循环和温血心脏停搏液对大脑的影响存在争议。S100蛋白是脑损伤的早期标志物,在冷血体外循环后已被检测到。我们研究了20例接受冠状动脉搭桥手术的患者在使用温血心脏停搏液(37℃)进行温体外循环(34 - 37℃)前后的S100浓度。S100蛋白的峰值水平在温体外循环后立即出现,然后逐渐下降,直到体外循环后4.5小时的最后一次测量。峰值水平似乎取决于患者的年龄,回归方程如下:y = -3.2 + 0.08x,其中y是S100蛋白浓度(微克/升),x是患者年龄(岁)。需要进一步研究来探讨这种早期释放模式的临床意义。在研究体外循环后S100蛋白水平时应考虑患者年龄。