S100B in cardiac surgery brain monitoring: friend or foe?

• Published in: Clinical chemistry and laboratory medicine Vol. 60; no. 3; pp. 317 - 331
• Main Authors: Lapergola, Giuseppe, Graziosi, Alessandro, D’Adamo, Ebe, Brindisino, Patrizia, Ferrari, Mariangela, Romanelli, Anna, Strozzi, Mariachiara, Libener, Roberta, Gavilanes, Danilo A. W., Maconi, Antonio, Satriano, Angela, Varrica, Alessandro, Gazzolo, Diego
• Format: Journal Article
• Language: English
• Published: Germany De Gruyter 23.02.2022; Walter De Gruyter & Company
• Subjects: Adult; Biomarkers; Biomarkers - metabolism; Brain - metabolism; Brain damage; Brain injury; cardiac surgery; Cardiac Surgical Procedures; cardiopulmonary bypass; Cardiopulmonary Bypass - methods; Cardiovascular diseases; Child; Coronary artery disease; Heart Defects, Congenital - etiology; Heart Defects, Congenital - metabolism; Heart Defects, Congenital - surgery; Heart diseases; Heart surgery; Humans; Hypoxia; Ischemia; Monitoring; Morbidity; neurobiomarker; neuromonitoring; Patients; Pediatrics; Proteins; Reperfusion; S100 Calcium Binding Protein beta Subunit - metabolism; S100B; S100b protein; Surgery; neuromonitoring; cardiopulmonary bypass; cardiac surgery; brain injury; neurobiomarker; S100B
• ISSN: 1434-6621; 1437-4331; 1437-4331
• DOI: 10.1515/cclm-2021-1012

Recent advances in perioperative management of adult and pediatric patients requiring open heart surgery (OHS) and cardiopulmonary bypass (CPB) for cardiac and/or congenital heart diseases repair allowed a significant reduction in the mortality rate. Conversely morbidity rate pattern has a flat trend. Perioperative period is crucial since OHS and CPB are widely accepted as a deliberate hypoxic-ischemic reperfusion damage representing the cost to pay at a time when standard of care monitoring procedures can be silent or unavailable. In this respect, the measurement of neuro-biomarkers (NB), able to detect at early stage perioperative brain damage could be especially useful. In the last decade, among a series of NB, S100B protein has been investigated. After the first promising results, supporting the usefulness of the protein as predictor of short/long term adverse neurological outcome, the protein has been progressively abandoned due to a series of limitations. In the present review we offer an up-dated overview of the main S100B and in the peri-operative monitoring of adult and pediatric patients.