The effect of cardiotomy suction on the brain injury marker S100 beta alter cardiopulmonary bypass

Background. An increase of Sloop in serum during cardiopulmonary bypass (CP B) has been interpreted as a sign of brain injury. Cardiotomy suction may c ause fat embolization, and its role in the Sloop increase was examined. Methods. Twenty coronary artery operation patients were randomly assigned t o two groups, 10 with suction during CPB to cardiotomy reservoir (CR), 10 t o cell saving device (CS). Sloop was measured (immunoassay) in blood from t he patients and from cell saving device after processing. In 7 additional p atients S100 beta was measured in the cell saving device before processing and directly from the wound at sternotomy. Results. Before anesthesia, serum Sloop was 0.03 +/- 0.06 mu g/L. At the en d of CPB it was 2.47 +/- 1.31 mu g/L. and 0.44 +/- 0.27 mu g/L (CR vs CS; p < 0.001). S100 beta was 33 +/- 12 mu g/L in CS reservoir and 42 +/- 18 mu g/L in blood from the wound. Conclusions. Most serum Sloop after CPB with cardiotomy suction may be of e xtracerebral origin. Sloop after CPB with cell saving device was the same a s after off-pump operation. The interpretation that an increase in Sloop du ring CPB in patients reflects cerebral injury must be questioned.