Phentolamine administration increases blood S100B protein levels in pediatric open-heart surgery patients

Fabrizio Michetti, Diego Gazzolo, Paolo Masetti, Maria Kornacka, Raul Abella, Pierluigi Bruschettini

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)

Abstract

AIM: Phentolamine administration during open-heart surgery shortens the cooling and rewarming phases of cardiopulmonary bypass (CPB) and hastens weaning from mechanical ventilation and extubation. Data on the effects of phentolamine on cerebral circulation and function in this setting are lacking. This study reports the cerebral effects of phentolamine using blood S100B protein levels and the middle cerebral artery pulsatility index (MCA PI). METHODS: Sixty pediatric patients undergoing congenital heart disease repair were randomly assigned to receive either phentolamine 0.2 mg kg(-1) i.v. (n = 30) or placebo (n = 30) before the cooling and rewarming phases of CPB. Samples for S100B measurement were collected at seven predetermined time-points before, during and after surgery. MCA PI values were recorded at the same times as sampling. RESULTS: S100B blood levels were higher in the phentolamine-treated group than in controls after rewarming (3.53 +/- 1.88 vs 1.58 +/- 0.53 microg l(-1); p < 0.001), remained persistently higher at the end of surgery (2.95 +/- 0.91 vs 0.79 +/- 0.21 microg l(-1); p < 0.001) and returned to normal ranges 12 h later than in the placebo group (p > 0.05). MCA PI values were also significantly higher at the end of surgery in the phentolamine-treated group (1.83 +/- 0.50 vs 1.22 +/- 0.34; p < 0.01). Cooling and rewarming times were shorter in the phentolamine-treated group (p < 0.01, for all). CONCLUSION: Despite improved peripheral vasodilatation and perfusion, phentolamine administration in pediatric open-heart surgery is correlated with increased cerebrovascular resistance and brain damage.
Original languageEnglish
Pages (from-to)1427-1432
Number of pages6
JournalACTA PAEDIATRICA
Publication statusPublished - 2003

Keywords

  • S100B protein
  • cardiopulmonary bypass
  • cerebral doppler
  • congenital heart disease
  • phentolamine

Fingerprint

Dive into the research topics of 'Phentolamine administration increases blood S100B protein levels in pediatric open-heart surgery patients'. Together they form a unique fingerprint.

Cite this