S100 beta correlates with neurologic complications after aortic operation using circulatory arrest

Background. Astrocyte protein S100 beta is a potential serum marker for neu rologic injury. The goals of this study were to determine whether elevated serum S100 beta correlates with neurologic complications in patients requir ing hypothermic circulatory arrest (HCA) during thoracic aortic repair, and to determine the impact of retrograde cerebral perfusion (RCP) on S100 bet a release in this setting. Methods. Thirty-nine consecutive patients underwent thoracic aortic repairs during HCA; RCP was used in 25 patients. Serum S100 beta was measured preo peratively, after cardiopulmonary bypass, and 24 hours postoperatively. Results. Neurologic complications occurred in 3 patients (8%). These patien ts had higher postbypass S100 beta levels (7.17 +/- 1.01 mug/L) than those without neurologic complications (3.63 +/- 2.31 mug/L, p = 0.013). Patients with S100 beta levels of 6.0 mug/L or more had a higher incidence of neuro logic complications (3 of 7,43%) compared with those who had levels less th an 6.0 mug/L (0 of 30, p = 0.005). Retrograde cerebral perfusion did not af fect S100 beta release. Conclusions. Serum S100 beta levels of 6.0 mug/L or higher after HCA correl ates with postoperative neurologic complications. Using serum S100 beta as a marker for brain injury, RCP does not provide improved cerebral protectio n over HCA alone.