Skip to main content
Log in

Serum S100B Protein Could Help to Detect Cerebral Complications Associated with Extracorporeal Membrane Oxygenation (ECMO)

  • Original Article
  • Published:
Neurocritical Care Aims and scope Submit manuscript

Abstract

Background

To investigate if serum S100B protein levels could early detect cerebral complications under treatment extracorporeal membrane oxygenation (ECMO).

Methods

Serum S100B levels were measured over 5 days in 32 patients with cardiogenic and septic shock, including 15 patients who treated by ECMO and 17 who did not. Cerebral complications included hemorrhage, stroke, encephalopathy with myoclonus, and brain death. Delirium was identified by the positive Confusion Assessment Method in the ICU.

Results

S100B levels were elevated in 24/32 patients (75 %) at ICU admission. Five patients developed cerebral complications (2 hemorrhages with 1 brain death, 1 encephalopathy with myoclonus in the ECMO group and 2 strokes in the non-ECMO group). At day 5, S100B levels were higher in the 5 patients with cerebral complications than in the 27 without cerebral complications, regardless of ECMO (0.426 [0.421, 0.652] vs. 0.102 [0.085, 0.135] μg/L, p = 0.011). S100B levels were also more elevated in 3 patients with than in 12 without cerebral complications associated with ECMO (0.799 [0.325, 0.965] vs. 0.102 [0.09, 0.607] μg/L, p = 0.033). S100B levels were not associated with delirium after sedation withdrawal.

Conclusions

Measurement serum S100B could be useful to detect cerebral complications in deeply sedated patients associated with ECMO but not for monitoring delirium after sedation withdrawal.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Marasco SF, Lukas G, McDonald M, McMillan J, Ihle B. Review of ECMO (extracorporeal membrane oxygenation) support in critically ill adults patients. Heart Lung Circ. 2008;17S:S41–7.

    Article  Google Scholar 

  2. Hervey-Jumper SL, Annich GM, Yancon AR, Garton HJ, Murasszko KM, Maher CO. Neurological complications of extracorporeal membrane oxygenation in children. J Neurosurg Pediatr. 2011;7:338–44.

    Article  PubMed  Google Scholar 

  3. Mateen FJ, Muralidharam R, Shinohara RT, Parisi JE, Schears GJ, Wijdicks EF. Neurological injury in adults treated with extracorporeal membrane oxygenation. Arch Neurol. 2011;68:1543–9.

    Article  PubMed  Google Scholar 

  4. Short BL. The effect of extracorporeal life support on the brain: a focus on ECMO. Semin Perinatol. 2005;29:45–50.

    Article  PubMed  Google Scholar 

  5. Risnes I, Wagner K, Nome T, Sundet K, Jensen J, Hynas IA, Ueland T, Pedersen T, Svennevig JL. Cerebral outcome in adult patients treated with extracorporeal membrane oxygenation. Ann Thorac Surg. 2006;81:1401–7.

    Article  PubMed  Google Scholar 

  6. McLaren G, Combes A, Bartlett RH. Contemporary extracorporeal membrane oxygenation for adult respiratory failure life support in the new era. Intensive Care Med. 2012;38:210–20.

    Article  Google Scholar 

  7. Girard TD, Panharipande PP, Ely W. Delirium in the intensive care unit. Crit Care. 2008;12(suppl 3):S3.

    Article  PubMed Central  PubMed  Google Scholar 

  8. Cerejeira J, Firmino H, Vaz-Serra A, Mukaetova-Ladinskka EB. The neuroinflammatory hypothesis of delirium. Acta Neuropathol. 2010;119:737–54.

    Article  PubMed  Google Scholar 

  9. Janz DR, Abel TW, Jackson JC, Gunther ML, Heckers S, Wesley E. Brain autopsy findings in intensive care unit patients previously suffering from delirium: a pilot study. J Crit Care. 2010;25:538e7–12.

    Article  Google Scholar 

  10. Sharshar T, Annane D, de la Grandmaison GL, Brouland JP, Hopkinson NS, Françoise G. The neuropathology of septic shock. Brain Pathol. 2004;14:21–33.

    Article  PubMed  Google Scholar 

  11. Muralidharan R, Mateen FJ, Shinohara RT, Schears GJ. The challenges with brain death determination in adult patients on extracorporeal membrane oxygenation. Neurocrit Care. 2011;14:423–6.

    Article  PubMed  Google Scholar 

  12. Chow FC, Edlow BL, Frosch MP, Copen WA, Greer DM. Outcome in patients with H1N1 influenza and cerebrovascular injury treated with extracorporeal membrane oxygenation. Neurocrit Care. 2011;15:156–60.

    Article  PubMed  Google Scholar 

  13. Gazzolo D, Masetti P, Grutzfeld D, Michetti F. Elevated S100B protein as an early indicator of intracranial hemorrhage in infants subjected to extracorporeal membrane oxygenation. Acta Pediatr. 2002;91:218–21.

    Article  CAS  Google Scholar 

  14. Townend W, Ingebrigtsen T. Head injury outcome prediction: a role for protein S-100B? Injury. 2006;37:1098–108.

    Article  PubMed  Google Scholar 

  15. Sen J, Belli A. S100B in neuropathologic states: the CRP of the brain? J Neurosci Res. 2007;85(7):1373–80.

    Article  CAS  PubMed  Google Scholar 

  16. Song KJ, Shin SD, Ong ME, Jeong JS. Can early serum levels of S100B protein predicts the prognosis of patients with out-of-hospital cardiac arrest. Resuscitation. 2010;81:337–42.

    Article  CAS  PubMed  Google Scholar 

  17. Van Munster BC, Korse CM, de Rooij SE, Bonfrer JM, Zwinderman AH, Korevaar JC. Markers of cerebral damage during delirium in elderly patients with hip fracture. BMC Neurol. 2009;9:21.

    Article  PubMed Central  PubMed  Google Scholar 

  18. Linstedt U, Meyer O, Kropp P, Berkau A, Zenz M. Serum concentration of S-100 protein in assessment of cognitive dysfunction after general anesthesia in different types of surgery. Acta Anaesthesiol Scand. 2002;46:384–9.

    Article  CAS  PubMed  Google Scholar 

  19. Nguyen DN, Spapen H, Su F, Schiettecatte J, Shi L, Hacimi-Idrissi S, Huyghens L. Elevated serum levels of S-100B protein and neuron-specific enolase are associated with brain injury in patients with severe sepsis and septic shock. Crit Care Med. 2006;34:1967–74.

    Article  CAS  PubMed  Google Scholar 

  20. Conti A, Lacopino DG, Spada A, Cardall SM, Giusa N, La Torre D, Campenni A, Penna O, Baldari S, Tomasello F. Transcranial Doppler ultrasonography in the assessment of cerebral circulatory arrest: improving sensitivity by transcervical and transorbital carotid insonation and serial examinations. Neurocrit Care. 2009;10:326–35.

    Article  PubMed  Google Scholar 

  21. Karasirajan V, Smedira NG, McCarthy JF, Casselman F, Boparai N, McCarthy PM. Risk factors for intracranial hemorrhage in adults on extracorporeal membrane oxygenation. Eur J Cardiothorac Surg. 1999;15:508–14.

    Article  Google Scholar 

  22. Heuer JF, Pelosi P, Hermann P, Perske C, Crozier TA, Brück W, Quintel M. Acute effects of intracranial hypertension and ARDS on pulmonary and neuron damage: a randomized experimental study in pigs. Intensive Care Med. 2011;37:1182–91.

    Article  PubMed Central  PubMed  Google Scholar 

  23. Jarjour IT, Ahbad-Barmada M. Cerebrovascular lesions in infants and children dying after extracorporeal membrane oxygenation. Pediatr Neurol. 1994;10:13–9.

    Article  CAS  PubMed  Google Scholar 

  24. Biehl DA, Stewart DL, Forti NH, Cook LN. Timing of intracranial hemorrhage during extracorporeal life support. ASAIO J. 1996;42:938–41.

    Article  CAS  PubMed  Google Scholar 

  25. Lidegran MK, Mosskin M, Ringertz HG, Bjőrn P, Freckner BP, Linden VB. Cranial CT for diagnosis of intracranial complications in adult and pediatric patients during ECMO: clinical benefits in diagnosis and treatment. Acad Radiol. 2007;14:62–71.

    Article  PubMed  Google Scholar 

  26. David L, Bellolio F. S100 as a marker of acute brain ischemia. Neurocrit Care. 2008;8:301–7.

    Article  Google Scholar 

  27. Raabe A, Kopetsch O, Woszczyk A, Lang J, Gerlach R, Zimmermann M, Seifert V. S100B protein as a serum marker of secondary neurological complications in neurocritical care patients. Neurol Res. 2004;24:440–5.

    Article  Google Scholar 

  28. Georgiadis D, Berger A, Kowatschev E, Lautenschläger C, Bőrner A, Lindner A, Schulte-Mattler W, Zerkowski HR, Zierz S, Deufel T. Predictive values of S100B and neuron-specific enolase serum levels for adverse neurologic outcome after cardiac surgery. J Thorac Cardiovasc Surg. 2000;119:138–47.

    Article  CAS  PubMed  Google Scholar 

  29. Ueno T, Iguro Y, Yamamoto H, Sakata R, Kakihana Y, Nakamura K. Serial measurement of serum S100B protein as a marker of cerebral damage after cardiac surgery. Ann Thorac Surg. 2003;75:1892–8.

    Article  PubMed  Google Scholar 

  30. Van Eldik LJ, Wainwright MS. The Janus face of glial-derived S100B: beneficial and detrimental functions in the brain. Restor Neurol Neurosci. 2003;21:97–108.

    PubMed  Google Scholar 

  31. Ohrt-Nissen S, Friis-Hansen L, Dahl B, Stensballe J, Rommer B, Rasmussen LS. How does extracerebral trauma affect the clinical values of S100B measurement. Emerg Med J. 2011;28:941–4.

    Article  PubMed Central  PubMed  Google Scholar 

  32. Pelinka LE, Harada N, Szalay L, Jafarmadar M, Redl H, Bahrami S. Release of S100B differs during ischemia and reperfusion of the liver, the gut, and the kidney in rats. Shock. 2001;21:72–6.

    Article  Google Scholar 

  33. Pham N, Fazio V, Cucullo L, Teng Q, Biberthaler P, Bazarian JJ, Janigro D. Extracranial sources of S100B do not affect serum levels. PLoS ONE. 2010;5:e12691.

    Article  PubMed Central  PubMed  Google Scholar 

  34. Yokota H, Ogawa S, Kukokawa A, Yamamoto Y. Regional cerebral blood flow in delirium patients. Psychiatry Clin Neurosci. 2003;57:337–9.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Duc Nam Nguyen.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nguyen, D.N., Huyghens, L., Wellens, F. et al. Serum S100B Protein Could Help to Detect Cerebral Complications Associated with Extracorporeal Membrane Oxygenation (ECMO). Neurocrit Care 20, 367–374 (2014). https://doi.org/10.1007/s12028-013-9874-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12028-013-9874-6

Keywords

Navigation