Shenfu Prevention Of Pediatric Cerebral Injury After Cardiopulmonary Bypass

Objective: The aim of this study was to observe the changes of S100βprotein,NSE,TNF-αand IL-6 in infants undergoing cardiac surgery with cardiopulmonary bypass(CPB),and the difference of the serum level of S100βprotein,NSE,TNF-αand IL-6 with and without Shenfu injection during cardiac surgery. And then determine the mechanisms of Shenfu injection which could decrease the release of the S100β,NSE,TNF-αand IL-6.This study can supply strong experimental evidences to using Shenfu injection in pediatric brain protection during CPB.Methods: Forty infants with congenital heart diseases who were below 3 years of age were election. They were randomly divided into two groups, one was the control group and another was the SF group. In SF group, all infants had been given Shenfu injection(1ml/kg) before CPB, and in the control group, NS(1ml/kg) was given by intravenous injection. Blood samples for the evaluation of serum levels of protein S100β,NSE,TNF-αand IL-6 were drawn immediately after induction of anaesthesia(T1) , immediately after CPB(T2) , immediately after aortic cross-clamping(T3), 20 minutes after the start of CPB(T4), immediately after the end of CPB(T5), 6h(T6) and. All data were analyzed with statistics methods. All patients in our study were evaluated 1 day before the operation and 60 days postoperatively with GESELL method.Results: In both groups,the serum level of S100βand NSE raised slowly, and reached the peak value (P <0.05) immediately after the end of CPB.In control group, the serum levels of S100βat 24h(T7) after operation was comparabal to those before operation(P >0.05) .But the level of NSE was still higher than pre-operation (P <0.05) at T7. The serum levels of S100βand NSE in the SF group were lower than control group at 20 minutes after the start of CPB. But there was no significant difference between the control group and the SF group at other measurement points .The levels of raised slowly, and reached the peak value at T4 (P <0.05). Then TNF-αand IL-6 concentrations decreased gradually , and reached the lever at immediately after induction of anaesthesia (P >0.05) at T7. But the level of NSE was still higher than pre-operation (P <0.05) at T7. The TNF-αlevel in the SF group were lower than control group at T3,T4 and T7. But there was no significant difference between the control group and the SF group at other measurement points .in two groups, the points of DQ after operation were higher than pre-operation (P <0.05) . But there was no significant difference between the control group and the SF group.Conclusion: CPB can induce brain injury and the release of the cytokine. And SF injection have effects on cerebral protection.