Neurone-specific enolase and Sangtec 100 assays during cardiac surgery: part III

Abstract

Neurone-specific enolase (NSE) and Sangtec 100 (S-100) are useful for detecting cerebral damage during cardiopulmonary bypass (CPB). However, red cells contain NSE, and the haemolysis frequently caused by CPB could produce a false rise in NSE; S-100 is not found in red cells and should not be affected. We, therefore, compared the effects of haemolysis on NSE and S-100 to see if correction was necessary and possible.

From seven patients, serial dilutions of haemolysed red cells were added to plasma (1/64-1/2048), measured for absorption at 540 nm and assayed for NSE and S-100.

S-100 concentrations showed no change with haemolysis. Measured NSE increased significantly with haemolysis >1/512 (an increase of 6.6 μg/ml): a correction formula is presented. In 39/48 patients after CPB, mean haemolysis was <1/256 and would not need any correction. NSE and S-100 assay can, therefore, be used throughout CPB, which allows both glial and neuronal damage to be studied.

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References

Prolifigen NSE IRMA, Sangtec-100 IRMA instructions for use. AB Sangtec Medical, Bromma, Sweden .

Dasie JD , Lewis SM eds. Practical Haematology, 8th edn. Churchill Livingstone , 1995.

Johnsson P , Lundqvist C , Lindgren A , Ferencz I , Alling C , Ståhl E. Cerebral complications after cardiac surgery assessed by S-100 and NSE levels in blood . J Cardiothorac Vasc Anesth 1995; 9: 694-699 .

Johnsson P. Markers of cerebral ischemia after cardiac surgery . J Cardiothorac Vasc Anesth 1996; 10: 120-126 .

Westaby S , Johnsson P , Parry AJ et al. Serum S-100 protein: a potential marker for cerebral events during cardiopulmonary bypass . Ann Thorac Surg 1996; 61: 88-92 .

Schaarschmidt H , Prange HW , Reiber H. Neuron-specific enolase concentrations in blood as a prognostic parameter in cerebrovascular diseases . Stroke 1994; 25(3): 558-565 .

Usui A , Kato K , Murase M et al. Neural tissue-related protein (NSE, GO alpha, 28-kDa calbindin-D, S-l00b and CK-BB) in serum and CSF after cardiac arrest . J Neurol Sci 1994; 123(1-2): 134-139 .

Karkela J , Bock E , Kaukinen S. CSF and serum brain-specific creatine 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; 116(1): 100-109 .

Backstrom M , Lundquist C , Stahl L-O et al. S-100 and NSE in blood after open heart surgery, correlation to neuropsychological outcome, preliminary findings . The Third International Conference, The Brain and Cardiac Surgery 1994; September: session four - monitoring.

10.

Johnsson P , Lundquist C , Lindgren A et al. Cerebral dysfunction after cardiac surgery: assessment by two biochemical markers in blood, S-100 and NSE . The Third International Conference, the Brain and Cardiac Surgery, September 1994: session four - monitoring.

11.

Sandström E , Karlsson K , Koskinen L-O et al. S-100: a biochemical marker for cerebral injury during cardiac surgery . The Third International Conference, The Third International Conference, the Brain and Cardiac Surgery, September 1994: session four - monitoring.

Neurone-specific enolase and Sangtec 100 assays during cardiac surgery: part III - does haemolysis affect their accuracy?

Abstract

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