Original ArticlesNeuron-specific enolase increases in plasma during and immediately after extracorporeal circulation
Section snippets
Material and methods
Sixteen consecutive patients scheduled for elective open heart surgery were studied. Patients with a history of cerebral disease were excluded from the study. Informed consent was obtained and the study protocol was approved by the Ethics committee of the University. Indications for surgery were coronary disease in 14 patients and valvular disease in 2 patients. The male/female ratio was 12:4, and the median age was 63 years (range 30 to 78 years). The anesthetic procedure was similar in all
Results
The peri- and postoperative course was uneventful in all patients included in the study. The median time of ECC was 86 minutes (range 35 to 144 minutes). The serum levels of NSE are shown in Figure 1. The mean time between administration of heparin, when the first blood sample was drawn, and the end of ECC (t = 0) was 120 minutes (range 78 to 134 minutes). The mean perfusion time was 86 minutes (range 36 to 144 minutes) (Table 1). NSE concentrations were within normal levels until the end of
Comment
The results of this study show that there is a release of NSE to plasma during ECC. To a part, this release can be attributed to hemolysis caused by the destruction of erythrocytes and platelets during ECC. Two earlier studies have reported attempts to correlate the release of NSE to the degree of hemolysis in the same sample. According to the first [6], even limited hemolysis can increase NSE levels by 5 to 10 μg/L, but no relationship between the degree of hemolysis and the release of NSE was
Acknowledgements
This study was in part supported by grants from Sangtec AB, Bromma, Sweden.
References (19)
- et al.
Cerebral consequences of cardiopulmonary bypass
Lancet
(1986) - et al.
Jugular bulb saturation and cognitive dysfunction after cardiopulmonary bypass
Ann Thorac Surg
(1994) - et al.
Neural tissue-related proteins (NSE, G0α, 28-kDa calbindin-D, S-100b and CK-BB) in serum and cerebrospinal fluid after cardiac arrest
J Neurol Sci
(1994) - et al.
CSF and serum brain-specific creatinine kinase isoenzyme (CK-BB), neuron-specific enolase (NSE) and neural cell adhesion molecule (NCAM) as prognostic markers for hypoxic brain injury after cardiac arrest in man
J Neurol Sci
(1993) - et al.
Cerebral complications after cardiac surgery assessed by S-100 and NSE levels in blood
J Cardiothorac Vasc Anesth
(1995) - et al.
Early intellectual dysfunction following coronary bypass surgery
Q J Med
(1986) Perioperative cardiac morbidity
Anesthesiology
(1990)- et al.
Neuron-specific enolase is a molecular marker for peripheral and central neuroendocrine cells
Nature
(1978) - et al.
Purification and characterization of human neuron-specific enolaseradioimmunoassay method
Tumor Biol
(1984)
Cited by (141)
Colloidal therapeutics in the management of traumatic brain injury: Portray of biomarkers and drug-targets, preclinical and clinical pieces of evidence and future prospects
2023, Colloids and Surfaces B: BiointerfacesAnalysis of the 2020 EACTS/ELSO/STS/AATS Expert Guidelines on the Management of Adult Postcardiotomy Extracorporeal Life Support
2022, Journal of Cardiothoracic and Vascular AnesthesiaCitation Excerpt :Computed tomography imaging should be used during clinical suspicion of neurologic injury but may be prohibited by transport risk due to instability. The biomarker neuron-specific enolase has shown potential for prognostication but, due to its sensitivity to hemolysis, has limited use in ECLS.132 The expert consensus to consider electroencephalography, somatosensory-evoked potentials, near-infrared spectroscopy, and TCD is reasonable, because these modalities are noninvasive and potentially can detect early signs of cerebral ischemia.
Neurochemical biomarkers of acute spinal cord injury
2022, Neural Repair and Regeneration after Spinal Cord Injury and Spine Trauma