The Changes of Brain Injury Markers (S100-beta, Neuron-Specific enolase) After Retrograde Cerebral Perfusion Under Total Circulatory Arrest in Pigs

Kim, Sang Yun; Kim, Man Ho; Kim, Kyung Hwan

Abstract

BACKGROUND: We previously published the data that proved the safety of retrograde cerebral perfusion for 120 minutes. At this time, we planned to check the neuron-specific enolase and S100-beta in serum and urine to assess the possibility of early detection of cerebral injury. MATERIAL AND METHOD: We used pigs(Landrace species) weighing 35 kg and performed RCP for 120 minutes. After the weaning of cardiopulmonary bypass, we observed the pigs for another 120 minutes. Systemic arterial pressure, central venous pressure, and serum and urine levels of neuron-specific enolose (NSE) and S100beta protein were checked. Central venous pressure during RCP was maintained in the range of 20 to 25 mmHg. RESULT: Serum levels of NSE(ng/ml) were 0.67+/-0.18(induction of anesthesia), 0.53+/-0.47(soon after CPB), 0.44+/-0.27(20min after CPB), 0.24+/-0.09(RCP 20min), 0.37+/-0.35(RCP 40min), 0.33+/-0.21(RCP 60min), 0.37+/-0.22(RCP 80min), 0.41+/-0.23(RCP 100 min), 0.48+/-0.26(RCP 120min), 0.42+/-0.29(30min after rewarming), 0.35+/-0.32(60min after rewarming, 0.42+/-0.37(CPBoff 30min), 0.47+/-0.34(CPBoff 60min), 0.47+/-0.28(CPBoff 90min), and 0.57+/-0.29(CPBoff 120min). There was no statistically significant difference in levels between before and after RCP(ANOVA, p>0.05). Urine levels of NSE also showed no statistically significant difference in levels between before and after RCP. There was no correlation between urine and serum levels of NSE(Pearson correlation, p>0.05). Serum levels of S100beta protein(ng/ml) during the same time frames were 0.14+/-0.08, 0.15+/-0.07, 0.22+/-0.15, 0.23+/-0.07, 0.28+/-0.10, 0.40+/-0.05, 0.47+/-0.03, 0.49+/-0.12, 0.43+/-0.11, 0.46+/-0.15, 0.62+/-0.17, 0.77+/-0.21, 0.78+/-0.23, 0.77+/-0.23, and 0.82+/-0.33. There was statistically significant difference in levels between before and after RCP(ANOVA, p<0.05). Urine levels of NSE also showed statistically significant difference in levels between before and after RCP(ANOVA, p<0.05). There was significant correlation between urine and serum levels of NSE(Pearson correlation, p<0.05).
CONCLUSION
The author observed the increase in serum and urine levels of S100beta after 120 minutes of RCP. Significant correlation between serum and urine levels was observed. The results were considered to be the fundamental data that could correlate this study with human-based study.