Oxidant-Antioxidant Balance during On-Pump Coronary Artery Bypass Grafting

Abstract

Backround. The aim of this study was to evaluate the changes in perioperative oxidant-antioxidant balance in ONCABG. Methods. Twenty-three patients were included in this study. Serum total oxidant status (TOS), total antioxidant status (TAS), and oxidative stress index (OSI) values were assessed preoperatively, at 20 minutes after aortic clamping and at 30 minutes, 6 hours, and 48 hours after declamping (reperfusion). The patients were divided into 2 groups according to the median aortic cross clamping (XC) time: group 1 (XC time < 42 minutes) and group 2 (XC time ≥ 42 minutes). Results. TOS and OSI values of whole patients at 30 minutes after reperfusion were higher than preoperative values (P = 0.045, P = 0.015), while perioperative TAS levels of the patients were similar to the preoperative levels (P = 0.173). XC time was correlated with TOS levels at 30 minutes after reperfusion (r = 0.43, P = 0.041). In group 2, TOS and OSI values at 30 minutes after reperfusion were higher than preoperative values (P = 0.023, P = 0.048), whereas a significant difference was not found in group 1 (P = 0.601, P = 0.327). Conclusions. Oxidative imbalance and increase in TOS at reperfusion in ONCABG may be associated with XC time.

Change in Free Radical and Antioxidant Enzyme Levels in the Patients Undergoing Open Heart Surgery with Cardiopulmonary Bypass

“…Previous studies revealed that the increase in total peroxide, 8-isoprostane, nitrite-nitrate levels, and oxidative stress caused by the cross clamp period in CABG patients were correlated [22]. Again, in the study of Mentese et al [19], it was found that the oxidant/antioxidant balance was not affected in ONCABG patients having short cross clamp periods (29 minutes). CPB is correlated with the formation of ROS production and oxidative stress [2].…”

“…CABG induces the excessive production of ROS such as hydroxyl, hydrogen peroxide, hypochlorite, and superoxide from various enzymatic and cellular sources [3]. In the study of Mentese et al [19] the increase in ROS was observed in ONCABG patients. Despite a significant increase in GSH level and CAT, GPx, and SOD activities in postoperative period, significant inhibition of increase in MDA in postoperative period was not shown in the present study.…”

“…The increase in MDA level in postoperative period in the present study was compatible with the previous studies. It is reported that the most important factor in the degradation of oxidative balance in ONCABG is reperfusion [19]. It is considered that various factors such as surgical damage, CPB, and ischemia-reperfusion damage cause oxidative stress in ONCABG patients [20].…”

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

“…Explanation for the primary mechanisms causing systemic inflammatory response (SIR) and oxidative stress during cardiac surgery includes the exposure of blood to synthetic material of ECC systems, the surgical trauma itself, and the sudden temperature changes of the body [8]. The close connection between ROS production, unphysiological circulation, and SIR during CPB is very well-known both with coated and noncoated ECC systems [13, 14]. Current studies have described the status of oxidative burden and the time course of their formation during CPB [15].…”

“…These are all sources of ROS production which will ultimately lead to depletion of plasma antioxidants. Coronary artery bypass surgery under CPB may possess an elevation in oxidant status and accordingly to this increase may raise antioxidant status [14]. …”