Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Клиническое исследование биохимических маркеров ишемии спинного и головного мозга при операциях на грудном и торакоабдоминальном отделах аорты

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Link: Clinical Physiology of Blood Circulaiton. 2012; (): -

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Abstract

Objective. To determine the role of biochemical markers of ischemia in diagnostics of neurological complications during the thoracic and thoracoabdominal aortic surgeries. Material and methods. The study included 45 patients operated on thoracic and thoracoabdominal aorta under cardiopulmonary bypass between November 2008 and July 2011. Patients were divided into 2 groups: 40 patients without neurological complications and 5 patients with neurological complications. Additional liquor test was performed in 23 patients with venous pathology in order to determine the range of normal value for S-100 protein in liquor. Lactate, S-100 protein, glucose, electrolytes and gases in liquor and blood were assessed. Results. Neurological complications developed in 5 patients (3 of them had spinal cord ischemia, 2 patients had acute cerebrovascular accident). Hospital mortality was 6.6% (3 patients). Statistical analysis showed that increased level of lactate (more than 2.0 mmol/l in 15 minutes after aortic clamping) and S-100 protein (more than 1.4 mcmol/l in 6 hours after aortic clamping) in liquor was associated with neurological complications after surgery. Other rates did not differ significantly between groups. Conclusion. Lactate level in liquor was the early predictor of spinal and cerebral ischemia. Evaluation of S-100 protein in liquor is a high specific diagnostic tool for spinal or cerebral ischemia in early postoperative period.

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