Comparative Effects of Blood and Crystalloid Cardioplegia on Cellular Injury and Oxidative Stress in Cardiovascular Surgery


ULUGOL H., Aksu U., KOÇYİĞİT M., Kilercik M., Karduz G., Okten M., ...Daha Fazla

ANNALS OF THORACIC AND CARDIOVASCULAR SURGERY, sa.1, ss.10-17, 2019 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Basım Tarihi: 2019
  • Doi Numarası: 10.5761/atcs.oa.18-00113
  • Dergi Adı: ANNALS OF THORACIC AND CARDIOVASCULAR SURGERY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.10-17
  • Anahtar Kelimeler: cardiovascular surgery, cardioplegic solutions, endothelial glycocalyx, sialic acid, ACUTE KIDNEY INJURY, SIALIC-ACID, ENDOTHELIAL GLYCOCALYX, PROTEIN PRODUCTS, CARDIOPULMONARY BYPASS, PLASMA, ISCHEMIA, INFLAMMATION, HEMOGLOBIN, BIOMARKERS
  • İstanbul Üniversitesi Adresli: Evet

Özet

Purpose: The purpose of this study was to evaluate the effect of different cardioplegic solutions on endothelial integrity and oxidative stress in cardiovascular surgery. Methods: In this randomized prospective study, after ethics approval and informed consent, 60 surgical patients were included. Patients undergoing coronary bypass surgery were randomized into two groups as warm blood cardioplegia (n = 30) and cold crystalloid cardioplegia (n = 30) following the cross-clamping. Measurements were performed at three time points: before induction of anesthesia (Ti), at admission to intensive care unit (ICU) (T2) and at the 24th postoperative hour (T3). Besides biochemical routine hemodynamic monitoring, patients were assessed for the sialic acid (SA), ischemic-modified albumin (IMA), advanced oxide protein products (AOPPs), total thiol (SH), and free hemoglobin (fHb) level. Results: Neither crystalloid nor blood cardioplegia led to significant changes in the AOPPs, T-SH, and SA level (p >0.05). Crystalloid cardioplegia, however, increased IMA level compared to both baseline (p <0.01) and blood cardioplegia group (p <0.05). fHb levels were transiently increased in both groups at the second-time point (p <0.001). fHb level was lower in the crystalloid group compared to that in the other group (p <0.05) at T2. Conclusion: Cardioplegia type creates similar effects on glycocalyx integrity. However, myocardial protection could be provided with warm blood cardioplegia.