Oxidative stress during extracorporeal circulation

Abstract

There is an increased oxidative stress response in patients having cardiac surgery, haemodialysis or extracorporeal membrane oxygenation that is related to poorer outcomes and increased mortality. Exposure of the patients' blood to the artificial surfaces of these extracorporeal devices, coupled with inflammatory responses, hyperoxia and the pathophysiological aspects of the underlying illness itself, all contribute to this oxidative stress response. Oxidative stress occurs when there is a disruption of redox signalling and loss of control of redox balance. Ongoing oxidative stress occurring during extracorporeal circulation (ECC) results in damage to lipids, proteins and DNA and contributes to morbidity and mortality. This review discusses reactive species generation and the potential clinical consequences of oxidative stress during ECC as well as provides an overview of some current antioxidant compounds that are available to potentially mitigate the oxidative stress response.

Unfermented grape juice reduce genomic damage on patients undergoing hemodialysis

“…Many studies have focused on the detection of oxidative stress in patients with renal alterations to determine whether this is an underlying cause/effect mechanism in chronic kidney disease (CKD). At this point, it must be indicated that CKD patients under dialysis (HD) are submitted to a continuous oxidative stress (McDonald et al, 2014). The HD process contribute to the elimination of plasma antioxidants and together with the dietary restrictions of these patients, the reduced antioxidant enzyme activity, and iron and erythropoietin supplements, these patients became a group with potentially high levels of ROS (Sportman et al, 2008).…”

The impact of acute lung injury, ECMO and transfusion on oxidative stress and plasma selenium levels in an ovine model

“…Excessive ROS production during sepsis, systemic inflammation and/or ischaemia-reperfusion injury has been associated with cellular, tissue and ultimately organ injury [9]. Additionally, extracorporeal circuits (ECMO, dialysis, cardiac bypass) involve extensive blood contact with a foreign surface and this coupled with hyperoxia and massive blood transfusions have the potential to augment oxidative stress [10,11]. Whether oxidative stress in this setting contributes to the morbidity/mortality risk of patients on ECMO is unclear.…”

Relationship between high on aspirin platelet reactivity and oxidative stress in coronary artery by-pass grafted patients

“…This enhanced oxidative stress leads to cell damage resulting in various complications such as sepsis, myocardial injury and platelet activation [8,9]. Despite improvements in surgical techniques, anesthesia, and intensive care, cardiac surgery with use of extra corporeal circulation is associated with an inflammatory response.…”

“…Although the heart is protected during CABG, a certain level of ROS production still occurs [9,10]. Experimental and clinical studies support the pivotal role played by ROS in the mechanism of platelet activation [11,12], whereas impaired response to antiplatelet therapy is thought to underlie the increased risk of postoperative venous graft occlusions.…”