Our Summary

This research paper looks at recent advances in the management of patients undergoing open heart surgery, specifically adults and children with heart diseases. These advances have significantly reduced the death rate, but the rate of complications or morbidity hasn’t changed much. The paper discusses the challenges during the period around surgery because both open heart surgery and cardiopulmonary bypass (a procedure to take over the function of the heart and lungs during surgery) can cause a type of damage related to reduced oxygen supply to the body.

In this context, the authors mention the potential usefulness of measuring certain substances (called neuro-biomarkers) that could indicate early signs of brain damage during this perioperative period. They focus on a specific neuro-biomarker called S100B protein, which was initially thought to be a good predictor of neurological complications after surgery. However, the use of this protein has been largely abandoned due to a number of limitations. The researchers provide an updated review of the benefits and drawbacks of using S100B protein for monitoring patients during and after heart surgery.

FAQs

  1. What is the role of neuro-biomarkers in perioperative brain damage detection?
  2. What is the S100B protein and how has it been used in neuro-monitoring during cardiac surgery?
  3. Why was the S100B protein abandoned despite its promising results in predicting adverse neurological outcomes?

Doctor’s Tip

One helpful tip a doctor might tell a patient about brain surgery is to follow all post-operative instructions carefully, including taking prescribed medications, attending follow-up appointments, and avoiding activities that could put strain on the surgical site. It is also important to report any new or worsening symptoms to your healthcare provider immediately.

Suitable For

Patients who may be recommended for brain surgery include those with:

  • Brain tumors
  • Epilepsy that cannot be controlled with medication
  • Traumatic brain injuries
  • Blood vessel abnormalities in the brain
  • Hydrocephalus
  • Parkinson’s disease
  • Chiari malformation
  • Trigeminal neuralgia
  • Brain abscesses
  • Brain hemorrhages
  • Malformations of the brain

It is important to note that brain surgery is considered a last resort treatment option and is typically recommended when other treatments have not been successful or are not appropriate for the patient’s condition. Each patient’s case is unique and should be evaluated by a team of medical professionals to determine the best course of treatment.

Timeline

Before brain surgery:

  • Patient undergoes pre-operative evaluations, including imaging scans and blood tests
  • Patient meets with the surgical team to discuss the procedure and potential risks
  • Patient may undergo pre-operative physical therapy or other interventions to prepare for surgery
  • Patient may need to stop taking certain medications before surgery
  • Patient may need to fast before the surgery

After brain surgery:

  • Patient is closely monitored in the recovery room for any immediate complications
  • Patient may be transferred to the intensive care unit for further monitoring
  • Patient may experience pain, swelling, and discomfort at the surgical site
  • Patient may need to stay in the hospital for several days to recover
  • Patient may need physical therapy or rehabilitation to regain strength and function
  • Patient will have follow-up appointments with the surgical team to monitor progress and address any concerns.

What to Ask Your Doctor

  1. What specific brain surgery procedure do you recommend for my condition?
  2. What are the risks and potential complications associated with the surgery?
  3. How long will the recovery process be and what can I expect during that time?
  4. What kind of follow-up care will be needed after the surgery?
  5. Are there any alternative treatment options to consider?
  6. How experienced are you in performing this type of brain surgery?
  7. What is the success rate for this type of surgery in patients with similar conditions?
  8. How will my brain function be monitored during and after the surgery?
  9. What are the potential long-term effects or complications of the surgery?
  10. Are there any specific lifestyle changes or precautions I should take post-surgery to ensure the best possible outcome?

Reference

Authors: Lapergola G, Graziosi A, D’Adamo E, Brindisino P, Ferrari M, Romanelli A, Strozzi M, Libener R, Gavilanes DAW, Maconi A, Satriano A, Varrica A, Gazzolo D. Journal: Clin Chem Lab Med. 2022 Jan 11;60(3):317-331. doi: 10.1515/cclm-2021-1012. Print 2022 Feb 23. PMID: 35001583