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Total circulatory arrest (TCA) in deep hypothermia used in corrective surgery of complex cardiovascular malformations in children has been claimed to cause brain injury and altered psychomotor development.Near infrared spectroscopy (NIRS) allows in vivo determination of changes in cerebral oxygenated (HbO2), deoxygenated (Hb), and total haemoglobin (Hbt; the sum of Hb + HbO2). Relative changes in the redox state of cytochrome oxydase (cyt.aa3), the terminal enzyme in the mitochondrial respiratory chain, may provide information about the availability of oxygen at cellular level. The new tissue oxygenation index (TOI) provides information on the global tissue oxygenation. Measurement of protein S-100 is used as a marker of astroglial cell injury. Thus, change in intravascular and intracellular oxygenation states were measured by NIRS during and after TCA in a neonatal piglet model.

Understanding the pathophysiology and neuropathological changes that might be related to brain injury after surgical cardiac procedures using hypothermic cardiopulmonary bypass (CPB) with a period of circulatory arrest (TCA) is fundamental to the development of hemodynamic and pharmacological neuroprotective interventions. Therefore, the aim of this study was to evaluate the relationship between the regional immunohistochemical expression of S-100β in the brain and the serum kinetic patterns in rabbits undergoing CPB with a 60-minute period of TCA, followed by reperfusion and rewarming.