Author/Authors :
Kachoueian, Naser AJA University of Medical Sciences Tehran Iran AJA University of Medical Sciences, Tehran, Iran , Gorjipour, Farhad AJA University of Medical Sciences Tehran Iran AJA University of Medical Sciences, Tehran, Iran , Tirgarfakheri, Koroush AJA University of Medical Sciences Tehran Iran AJA University of Medical Sciences, Tehran, Iran , Tolouei Tabar, Yaser AJA University of Medical Sciences Tehran Iran AJA University of Medical Sciences, Tehran, Iran , Jadbabaie, Amirnaser AJA University of Medical Sciences Tehran Iran AJA University of Medical Sciences, Tehran, Iran , Bahlouli Ghashghaei, Sepideh AJA University of Medical Sciences Tehran Iran AJA University of Medical Sciences, Tehran, Iran , Ghasemy, Kambiz AJA University of Medical Sciences Tehran Iran AJA University of Medical Sciences, Tehran, Iran , Gorjipour, Sona AJA University of Medical Sciences Tehran Iran AJA University of Medical Sciences, Tehran, Iran , Mortazian, Meysam AJA University of Medical Sciences Tehran Iran AJA University of Medical Sciences, Tehran, Iran
Abstract :
Background: Cardiac surgeries in adults usually use cardiopulmonary bypass (CPB) for cardiac protection and provide a blood-free field for operation. However, due to changes in tissue perfusion and ischemia-reperfusion injury (IRI), there are some side effects for CPB operations. Lipid peroxidation and compromised antioxidant defense are consequences of IRI. This can, in turn, cause organ dysfunction and lead to unwanted biochemical and clinical changes.
Methods: In a cross-sectional study 107 patients with the ages of 35 to 79 years old matching the inclusion criteria with indication for elective on-pump CABG were studied. Renal function, serum malondialdehyde (MDA) and total antioxidant capacity (TAC), and clinical outcomes were studied until 24 hours after intensive care unit (ICU) admission. Correlations between MDA and TAC and other outcomes were tested. Between-group comparisons was one-way ANOVA with repeated measures was used for inferring changes in the plasma TAC and MDA levels, creatinine, and BUN over time. Correlations were investigated using regression models.
Results: Preoperative EF was inversely correlated with TAC at post- CPB time (r= -0.262, p= 0.031). Hyperlipidemia (HLP) was directly associated with higher MDA at post- CPB time (r= 0.267, p= 0.017. Cross-clamp and CPB duration were inversely correlated with the systemic MDA concentration at 24 hours post-ICU admission (r= -0.314, p= 0.005 and r= -0.312, p= 0.005, respectively). Preoperative TAC was inversely correlated with lactate at ICU admission (r= -0.294, p= 0.011). Creatine phosphokinase (CPK) and TAC were directly correlated with post-CPB time (r= -0.327, p= 0.006).
Conclusion: According to the findings, a direct correlation between TAC and myocardial protection during CPB exists. Reduced TAC during CPB is associated with elevation of muscle damage marker CPK. Preoperative HLP is associated with higher circulatory MDA content at the post-CPB time.
Keywords :
Cardiac Surgery , Cardiopulmonary Bypass , Oxidative Stress , Total Antioxidant Capacity , Lipid Peroxidation
