Cerebral electrical impedance value reflects brain edema caused by cardiopulmonary bypass in infants

ABSTRACT

The study aimed to investigate if the dynamic changes in cerebral electrical impedance [CEI] values could be used to monitor brain edema during cardiopulmonary bypass [CPB] in infants. Forty infants [mean age 1.4+/-0.38y] with acyanotic congenital heart disease who underwent CPB open-heart surgery between September 2009 and March 2010 were prospectively enrolled, and divided into 2 groups based on aortic cross-clamping [ACC] time CPB-A [ACC<50 min] and CPB-B [ACC>/=50 min]. During the same period, twenty infants [aged 1-3y] who underwent surgery for indirect inguinal hernias were selected as controls. Serum astrocyte S100 protein [S100] and neuron-specific enolase [NSE] levels were determined before and after CPB. Changes in CEI were detected using the BORN-BE system. No intraoperative death occurred. Compared with controls, left and right side CEI values, serum S100 and NSE levels in the CPB groups significantly increased from surgery beginning to end [P<0.05]. After surgery, these levels decreased [P<0.05]. Detection rates of cerebral edema in the CPB-B group 24h post-operative were significantly higher than in the CPB-A group [P<0.05]. CEI value can be used to dynamically monitor brain edema in infants undergoing CPB, and is an index reflecting brain damage during CPB in infants