Arterio-jugular differences in serum S-100β proteins in patients receiving selective cerebral perfusion

Purpose. The early increase in serum S100 beta after cardiopulmonary bypass (CPB) seems to be derived from an extracerebral source. To exclude contamination, we investigated the arterio-jugular differences in S100 beta levels in patients receiving selective cerebral perfusion (SCP). We also evaluated the brain-protective effect of SCP by comparing the arterial S100 beta levels with those in patients undergoing coronary artery bypass grafting (CABG). Methods.We measured arterial and jugular venous levels of S100 beta in ten patients undergoing aortic arch repair with SCP for up to 12h postoperatively (SCP group). We also measured arterial levels of S100 beta in nine patients undergoing CABG (CPB group). Results. There was no incidence of hospital death or stroke. The arterial levels of S100 beta in both groups were comparable and peaked just after the conclusion of CPB. The arterial and jugular venous levels of S100 beta were almost equivalent. The arterio-jugular differences in S100 beta levels were negligible, even in our SCP-group patient with postoperative delirium, who had a peak value three times higher than the other patients. Conclusions. The arterio-jugular differences in S100 beta did not clarify the origin of their increase. Thus, measuring the jugular venous levels of S100 beta in patients without postoperative clinical neurological deterioration would be of little benefit. However, SCP seems to protect the brain against S100 beta release as effectively as conventional CPB.