Document Detail


The effect of zero-balanced ultrafiltration during cardiopulmonary bypass on S100b release and cognitive function.
MedLine Citation:
PMID:  12705644     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Zero-balanced ultrafiltration (ZBUF) might reduce the systemic inflammatory response (SIRS) during cardiopulmonary bypass (CPB) by removing inflammatory mediators. The objective of this study was to determine the effect of ZBUF on postoperative serum S100b levels, a marker of neuronal injury. In addition, the possible effects of ZBUF on postoperative neurocognitive function were assessed. Sixty patients undergoing elective coronary bypass grafting were randomly assigned either to a control group or to a protocol group in which ZBUF was performed. Serum S100b levels were measured five minutes after intubation, at the end of bypass and eight and 20 hours after arrival at the intensive care unit (ICU). Cognitive function was assessed with neuropsychological tests on the day before the operation and the sixth day after surgery. The S100b level at 20 hours after arrival at the ICU was 0.27 g/L (SD 0.16) in the control and 0.25 g/L (SD 0.12) in the group with ZBUF. There were no statistical differences at any time between the two groups. S100b was not detectable in the ultrafiltrate, indicating that these results were not obscured by washout of S100b. Thirteen patients (52%) in the control group and 14 patients (56%) in the ZBUF group showed a cognitive deficit. In conclusion, ZBUF during CPB does not decrease the release of S100b. This result is not affected by washout. ZBUF did not reduce the incidence of early neurocognitive deficits. The role of SIRS in the development of cognitive dysfunction following CPB remains to be resolved.
Authors:
M de Baar; J C Diephuis; K G M Moons; J Holtkamp; R Hijman; C J Kalkman
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Perfusion     Volume:  18     ISSN:  0267-6591     ISO Abbreviation:  Perfusion     Publication Date:  2003 Mar 
Date Detail:
Created Date:  2003-04-22     Completed Date:  2003-12-12     Revised Date:  2005-11-04    
Medline Journal Info:
Nlm Unique ID:  8700166     Medline TA:  Perfusion     Country:  England    
Other Details:
Languages:  eng     Pagination:  9-14     Citation Subset:  IM    
Affiliation:
Department of Anaesthesiology, University Medical Centre Utrecht, Utrecht, The Netherlands. m.baar@anest.azu.nl
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MeSH Terms
Descriptor/Qualifier:
Aged
Cardiopulmonary Bypass / adverse effects*,  methods
Cognition*
Female
Hemofiltration / standards*
Humans
Inflammation / etiology,  prevention & control
Inflammation Mediators / blood
Male
Middle Aged
Nerve Growth Factors / blood*
Postoperative Complications / prevention & control
S100 Proteins / blood*
Time Factors
Chemical
Reg. No./Substance:
0/Inflammation Mediators; 0/Nerve Growth Factors; 0/S-100 calcium-binding protein beta subunit; 0/S100 Proteins

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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