Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-26T12:08:29.707Z Has data issue: false hasContentIssue false

Alterations in antioxidant and oxidant status of children after on-pump surgery for cyanotic and acyanotic congenital heart diseases

Published online by Cambridge University Press:  19 May 2016

Firat H. Altin*
Affiliation:
Department of Pediatric Cardiovascular Surgery, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
Hayriye A. Yildirim
Affiliation:
Department of Biochemistry, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
Ibrahim C. Tanidir
Affiliation:
Department of Pediatric Cardiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
Okan Yildiz
Affiliation:
Department of Pediatric Cardiovascular Surgery, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
Meliha Z. Kahraman
Affiliation:
Department of Anesthesiology and Reanimation, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
Erkut Ozturk
Affiliation:
Department of Pediatric Cardiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
Sinem B. Celebi
Affiliation:
Department of Anesthesiology and Reanimation, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
Mugisha Kyaruzi
Affiliation:
Department of Pediatric Cardiovascular Surgery, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
İhsan Bakir
Affiliation:
Department of Pediatric Cardiovascular Surgery, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
*
Correspondence to: F. H. Altin, MD, Istanbul Mehmet Akif Ersoy Thoracic And Cardiovascular Surgery Training and Research Hospital, Istasyon Mah.Turgut Ozal Bulvarı No:11 Kucukcekmece, Istanbul 34303, Turkey. Tel: +9 0212 692 20 00; Fax: +9 0212 471 94 94; E-mail: [email protected]

Abstract

Objective

Oxidative stress refers to an imbalance between reactive oxidative species and antioxidants. In this case-controlled, prospective, observational study, we investigated the total oxidant status, total antioxidant status, oxidative stress index, and albumin and C-reactive protein levels of children with cyanotic and acyanotic congenital heart diseases who had undergone on-pump cardiac surgery.

Method

The study groups consisted of 60 patients with congenital heart disease, who were operated under cardiopulmonary bypass, and a control group of 30 healthy individuals. The patients were classified into two groups. Among them, one was a patient group that consisted of 30 patients with acyanotic congenital heart disease and the other group consisted of 30 patients with cyanotic congenital heart disease. In the patient groups, blood samples were collected before surgery and at one and 24 hours following surgery. In control groups, blood samples were collected once during hospital admission.

Results

No statistically significant differences were found between the groups in terms of baseline total oxidant status, total antioxidant status, and oxidative stress index values. Regarding the postoperative first-hour and 24-hour total oxidant status and total antioxidant status levels as well as oxidative stress index values, there were no significant differences between the groups, except for an increase in total antioxidant status levels (p=0.002) 24 hours after surgery in cyanotic patients.

Conclusion

There was no difference between oxidative stress status of cyanotic and acyanotic congenital heart disease patients and healthy individuals. Oxidative stress status of cyanotic and acyanotic patients does not change after cardiac surgery under cardiopulmonary bypass.

Type
Original Articles
Copyright
© Cambridge University Press 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Biglioli, P, Cannata, A, Alamanni, F, et al. Biological effects of off-pump vs. on pump coronary artery surgery: focus on inflammation, hemostasis andoxidative stress. Eur J Cardiothorac Surg 2003; 24: 260269.Google Scholar
2. Atay, Y, Atay, A, Ayık, MF, et al. Antioxidant response after the operations for congenital heart diseases. Turk Gogus Kalp Dama 2012; 20: 722728.Google Scholar
3. Pyles, LA, Fortney, JE, Kudlak, JJ, Gustafson, RA, Einzig, S. Plasma antioxidant depletion after cardiopulmonary bypass in operations for congenital heart disease. J Thorac Cardiovasc Surg 1995; 110: 165171.Google Scholar
4. Erel, O. A novel automated direct measurement method for total antioxidant capacity using a new generation, morestable ABTS radical cation. Clin Biochem 2004; 37: 277285.CrossRefGoogle Scholar
5. Erel, O. A new automated colorimetric method for measuring total oxidant status. Clin Biochem 2005; 38: 11031111.Google Scholar
6. Mentese, U, Dogan, OV, Turan, I, et al. Oxidant-antioxidant balance during on-pump coronary artery bypass grafting. Scientific World Journal 2014; 2014: 263058.CrossRefGoogle ScholarPubMed
7. Lacour-Gayet, F, Clarke, D, Jacobs, J, et al. The Aristotle score: a complexity-adjusted method to evaluate surgical results. Eur J Cardiothorac Surg 2004; 25: 911924.CrossRefGoogle Scholar
8. Lacour-Gayet, F, Clarke, D, Jacobs, J, et al. The Aristotle score for congenital heart surgery. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2004; 7: 185191.Google Scholar
9. O’Brien, SM, Clarke, DR, Jacobs, JP, et al. An empirically based tool for analyzing mortality associated with congenital heart surgery. J Thorac Cardiovasc Surg 2009; 138: 11391153.CrossRefGoogle ScholarPubMed
10. Jenkins, KJ. Risk adjustment for congenital heart surgery: the RACHS-1 method. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2004; 7: 180184.Google Scholar
11. Lobo, V, Patil, A, Phatak, A, Chandra, N. Free radicals, antioxidants and functional foods: Impact on human health. Pharmacogn Rev 2010; 4: 118126.Google Scholar
12. Young, IS, Woodside, JV. Antioxidants in health and disease. J Clin Pathol 2001; 54: 176186.Google Scholar
13. Birben, E, Sahiner, UM, Sackesen, C, Erzurum, S, Kalayci, O. Oxidative stress and antioxidant defense. World Allergy Organ J 2012; 5: 919.CrossRefGoogle ScholarPubMed
14. Christen, S, Finckh, B, Lykkesfeldt, J, et al. Oxidative stress precedes peak systemic inflammatory response in pediatric patients undergoing cardiopulmonary bypass operation. Free Radic Biol Med 2005; 38: 13231332.CrossRefGoogle ScholarPubMed
15. Pirinccioglu, AG, Alyan, O, Kizil, G, Kangin, M, Beyazit, N. Evaluation of oxidative stress in children with congenital heart defects. Pediatr Int 2012; 54: 9498.Google Scholar
16. Ercan, S, Cakmak, A, Kosecik, M, Erel, O. The oxidative state of children with cyanotic and acyanotic congenital heart disease. Anadolu Kardiyol Derg 2009; 9: 486490.Google Scholar
17. Caputo, M, Mokhtari, A, Miceli, A, et al. Controlled reoxygenation during cardiopulmonary bypass decreases markers of organ damage, inflammation, and oxidative stress in single-ventricle patients undergoing pediatric heart surgery. J Thorac Cardiovasc Surg 2014; 148: 792801.Google Scholar
18. Gu, YJ, Schoen, P, Tigchelaar, I, et al. Increased neutrophil priming and sensitization before commencing cardiopulmonary bypass in cardiac surgical patients. Ann Thorac Surg 2002; 74: 11731179.Google Scholar
19. Chello, M, Mastroroberto, P, Quirino, A, et al. Inhibition of neutrophil apoptosis after coronary bypass operation with cardiopulmonary bypass. Ann Thorac Surg 2002; 73: 123130.CrossRefGoogle ScholarPubMed
20. Peters, T. All About Albumin: Biochemistry, Genetics, and Medical Applications. Academic Press, San Diego, CA, 1996.Google Scholar
21. Taverna, M, Marie, AL, Mira, JP, Guidet, B. Specific antioxidant properties of human serum albumin. Ann Intensive Care 2013; 3: 4.CrossRefGoogle ScholarPubMed