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Canadian Journal of Anesthesia 52:442-443 (2005)
© Canadian Anesthesiologists' Society, 2005

Correspondence

REPLY

Meral Kanbak, MD, Fatma Saricaoglu, MD and Turgay Ocal, MD

Hacettepe University, Ankara, Turkey, E-mail: orhankan{at}ttnet.net.tr

We welcome the opportunity to respond to the letter of Grocott. The points raised regarding extra cranial sources of S100ß protein are valid. As the biological half-life of S100ß protein is less than one hour.1 We selected a sampling time of 24 hr after cardiopulmonary bypass (CPB). Georgiadis and coworkers found that S100ß protein levels at 24 hr after CPB have a sensitivity and specificity of approximately 90% and 97% respectively.2 As Shaaban Ali mentioned, unless there is a ongoing auto transfusion from chest tubes, secondary or late release pattern of S100ß protein (15–48 hr) in the postoperative period is a sign of further neurological injury.3

Fazio et al.4 have demonstrated the limitations associated with the use of S100ß protein for the evaluation of brain damage and patients’ outcome during surgical procedures but they concluded that currently available methods used to measure serum S100ß protein are still valid for the evaluation of neurological disorders associated with brain damage. Filtering or immunepreabsorption of samples may be required to completely rule out cross contamination.

In addition to these, our study aimed to investigate the effect of anesthetics on the S100ß protein, and our groups were standardized for the surgical technique and measurements.

Prospective, large-scale, multicentre studies will be necessary to determine the exact origins of S100ß protein.

References

1 Jonsson H, Jonsson P, Alling C, Backstrom M, Bergh C, Blomquist S. S100ß after coronary artery surgey: release pattern, source of contamination, and relation to neuropsycological outcome. Ann Thorac Surg 1999; 68: 2202–8.[Abstract/Free Full Text]

2 Georgiadis D, Berger A, Kowatschev E, et al. Predictive value of S-100ß and neuron-specific enolase serum levels for adverse neurologic outcome after cardiac surgery. J Thorac Cardiovasc Surg 2000; 119: 138–47.[Abstract/Free Full Text]

3 Shaaban Ali M, Harmer M, Vaughan RS. Serum S100 protein as a marker of cerebral damage during cardiac surgery (Letter, reply). Br J Anaesth 2001; 86: 289–90.

4 Fazio V, Bhudia SK, Marchi N, Aumayr B, Janigro D. Peripheral detection of S100b during cardiothoracic surgery: what are we really measuring? Ann Thorac Surg 2004; 78: 46–53.[Abstract/Free Full Text]


Related articles in CJA:

S100ß and postcardiac surgery neurological dysfunction: reasons to disregard any link
Hilary P. Grocott
CJA 2005 52: 441-442. [Full Text]  




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