@Article{chd.12741,
AUTHOR = {Jan Hinnerk Hansen, Lydia Kissner, Jana Logoteta, Olaf Jung, Peter Dütschke, Tim Attmann, Jens Scheewe, Hans‐Heiner Kramer},
TITLE = {S100B and its relation to cerebral oxygenation in neonates and infants undergoing surgery for congenital heart disease},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {14},
YEAR = {2019},
NUMBER = {3},
PAGES = {427--437},
URL = {http://www.techscience.com/schd/v14n3/38787},
ISSN = {3071-1738},
ABSTRACT = {<b>Objectives:</b> Neonates and infants undergoing surgery for congenital heart disease
are at risk for developmental impairment. Hypoxic‐ischemic brain injury might be one
contributing factor. We aimed to investigate the perioperative release of the astro‐
cyte protein S100B and its relation to cerebral oxygenation.<br/>
<b>Methods:</b> Serum S100B was measured before and 0, 12, 24, and 48 hours after sur‐
gery. Cerebral oxygen saturation was derived by near‐infrared spectroscopy. S100B
reference values based on preoperative samples; concentrations above the 75th per‐
centile were defined as elevated. Patients with elevated S100B at 24 or 48 hours
were compared to cases with S100B in the normal range. Neonates (≤28 days) and
infants (>28 and ≤365 days) were analyzed separately due to age‐dependent release
of S100B.<br/>
<b>Results:</b> Seventy‐four patients underwent 94 surgical procedures (neonates, n = 38; 
infants, n = 56). S100B concentrations were higher in neonates before and after sur‐
gery at all time points (P ≤ .015). Highest values were noticed immediately after sur‐
gery. Postoperative S100B was elevated after 15 (40.5%) surgeries in neonates.
There was no difference in pre‐, intra‐, or postoperative cerebral oxygenation. In in‐
fants, postoperative S100B was elevated after 23 (41.8%) procedures. Preoperative
cerebral oxygen saturations tended to be lower (53 ± 12% vs 59 ± 12%, P = .069) and
arterial‐cerebral oxygen saturation difference was higher (35 ± 11% vs 28 ± 11%,
P = .018) in infants with elevated postoperative S100B. In the early postoperative
course, cerebral oxygen saturation was lower (54 ± 13% vs 63 ± 12%, P = .011) and
arterial‐cerebral oxygen saturation difference was wider (38 ± 11% vs 30 ± 10%,
P = .008). Cerebral oxygen saturation was also lower for the entire postoperative
course (62 ± 18% vs 67 ± 9%, P = .047).<br/>
<b>Conclusions:</b> Postoperative S100B was elevated in about 40% of neonates and in‐
fants undergoing cardiac surgery. Infants with elevated postoperative S100B had
impaired perioperative cerebral tissue oxygenation. No relation between S100B and
cerebral oxygenation could be demonstrated in neonates.},
DOI = {10.1111/chd.12741}
}