Oxidant Status following Cardiac Surgery with Phosphorylcholine-Coated Extracorporeal Circulation Systems

Abstract

Introduction. Extracorporeal circulation (ECC) related systemic oxidative stress is a well-known entity but the underlying mechanisms are not clearly described. Our aim was to investigate the relation between the oxidative stress indices, inflammatory markers, and phosphorylcholine-coated (PCC) ECC systems. Patients and Methods. Thirty-two consecutive coronary artery bypass grafting (CABG) cases were randomly assigned to Group I (PCC, n = 18) and Group II (noncoated, n = 14) ECC circuits. Total Antioxidant Status (TAS), Total Oxidant Status (TOS), Tumor Necrosis Factor-α (TNF-α), Interleukin-1β (IL-β), Interleukin-6 (IL-6), Interleukin-8 (IL-8), Interleukin-10 (IL-10), and Procalcitonin (PCT) levels were measured at 5 different time points. The association between the oxidative indices levels and PCC system used was analyzed. Results. In Group I TOS and TAS statuses were increased at T1, T2, T3, and T4, while IL-10 and TNF-α levels accompanied those raises only at T2 (Group I-Group II, 4.73 ± 2.04 versus 2.79 ± 0.63, p = 0.002, and 30.56 ± 8.11 versus 23.97 ± 7.8, p = 0.031, resp.). In contrast, mean TAS and TOS levels were similar to baseline at all time points in Group II but IL-6 and IL-8 levels were increased at T2 (Group I-Group II, 16.84 ± 5.63 versus 44.81 ± 17.0, p = 0.001, and 38.88 ± 9.8 versus 46.14 ± 9.25, p = 0.038, resp.). Conclusion. Even coated ECC systems are still incapable of attenuating the inflammatory response to cardiopulmonary bypass (CPB).

Dynamic changes of paraoxonase 1 activity towards paroxon and phenyl acetate during coronary artery surgery

“…Another authors assessing changes in total antioxidant capacity of plasma in patients undergoing CABG found progressive depletion of evaluated values after the beginning of surgery, what remains in concordance with our results regarding PON1 activity towards phenyl acetate [31]. Even in the experiment evaluating influence or potentially less harmful phosphorylcholine – coated extracorporeal circulation system a higher oxidative stress with elevated antioxidant reaction were observed [32]. Also in our study we found a significant decrease of PON1 activity after aorta clumping and then an increase after the end of the operation when cardiopulmonary bypass was not still used, but we did not observed a correlation between PON 1 activity and time of aorta clumping.…”

The Effect of Continuous Ventilation on Thiol-Disulphide Homeostasis and Albumin- Adjusted Ischemia-Modified Albumin During Cardiopulmonary Bypass

“…It is known that CABG surgery increases oxidative parameters and produces a strong antioxidant response [1-3,6,19] . Antioxidant capacity is seen as a predictive parameter in determining postoperative complications [20] .…”

“…Ischemia created during this process and following reperfusion can damage the myocardium. Inflammatory and systemic oxidative stress response caused by total cardiopulmonary bypass (CPB) causes endothelial damage in many systemic organs [1-3] , and this mechanism has been not fully explained yet. In addition, alveolar collapse, change in compliance of the chest wall, diaphragmatic dysfunction, lung and phrenic nerve trauma, splanchnic hypoperfusion, pulmonary ischemia/reperfusion (I/R), and use of protamine are also causes of the ischemic condition.…”

“…Due to the fact that the heart is the most exposed organ to severe I/R, various studies have investigated the relationship between CABG, various CBP systems, surgical methods, anesthesia methods, administration of trace elements and vitamin supplements to patients, and the antioxidant status of patients [1,2,10] . Although there are many studies on continuous ventilation in CABG, randomized studies are limited [11] .…”

L-carnitine supplementation in the recovery of plasma L-carnitine in patients with heart failure submitted to coronary artery bypass grafting

“…Plasma LC deficiency was not observed in the present study, although patients with HF may be deficient in nutrients important for cardiac metabolism, such as LC, coenzyme Q10, creatine, taurine and thiamine (Wong et al 2016). Surgical revascularization can improve myocardial perfusion but it may also cause increased production of free radicals and systemic infl ammatory stimuli (Hatemi et al 2016). These side eff ects may be responsible for the reduction of plasma LC observed after surgery.…”