title: Different profile of antioxidative capacity results in pulmonary dysfunction and amplified inflammatory response After CABG surgery.
abstract: BACKGROUND
  Respiratory complications after cardiosurgical interventions are frequent and cause severe problems, postoperatively. The present study addresses the question for group-specific release of radical oxygen species (ROS) by extracorporeal circulation (ECC) with emphasis on pulmonary function.
  
  
  METHODS
  Fifty-one patients who had undergone bypass surgery were evaluated for serum antioxidative capacity (AOC). Blood gas analysis, leukocyte counts, C-reactive protein (CRP), and hemodynamic data cardiac output (CO), pulmonary capillary wedge pressure (PCWP) arterial-alveolar gradient (AaDO(2)), and Murray scores were measured after ECC up to 48 h. According to AOC levels at baseline before ECC, patients were divided into two groups (group A: "high" AOC equal to or above median of the whole sample; n=26; versus group B: "low" AOC below median; n=25).
  
  
  RESULTS
  A different time course in AOC could be detected between both groups. Both groups had an improvement in postoperative cardiac output evaluation, but in group A (high AOC) the PCWP was reduced (P=0.015). In this group, an increased AaDO(2) and elevated Murray score were seen 12 h postoperatively (P<0.001), suggesting reduced oxygen uptake. Moreover, increased CRP values and a trend to reduced leukocyte counts indicate differences in amplified inflammatory response to ECC.
  
  
  CONCLUSIONS
  Free radical production after ECC is not a uniform process. Preoperative differences in AOC indicate interindividual variations. The surgical trauma results in a clear decrease of AOC in group A, while in group B AOC showed no major changes. As shown for reduced PCWP, release of ROS can affect pulmonary function. Therefore, AOC may be a useful parameter for prediction of postoperative complications.
authors.affiliation: Heart Surgery, Internal Medicine, Philipps University, Marburg, Germany. vogts@med.uni-marburg.de
authors.forename: Sebastian
authors.initials: S
authors.lastname: Vogt
authors.forename: Alexander
authors.initials: A
authors.lastname: Sattler
authors.forename: Abdul S
authors.initials: AS
authors.lastname: Sirat
authors.forename: Bernd
authors.initials: B
authors.lastname: Müller
authors.forename: Carola
authors.initials: C
authors.lastname: Seifart
authors.forename: Bernhard
authors.initials: B
authors.lastname: Maisch
authors.forename: Rainer G
authors.initials: RG
authors.lastname: Moosdorf
mesh_terms: D000328:Adult; D000368:Aged; D000975:Antioxidants / Q000378:metabolism*; D002097:C-Reactive Protein / Q000032:analysis; D002302:Cardiac Output; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D005260:Female; D018840:HSP70 Heat-Shock Proteins / Q000097:blood; D006801:Humans; D007249:Inflammation / Q000209:etiology*; D007958:Leukocyte Count; D008171:Lung Diseases / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011669:Pulmonary Wedge Pressure; D017382:Reactive Oxygen Species / Q000378:metabolism
chemical_list: D000975:Antioxidants; D018840:HSP70 Heat-Shock Proteins; D017382:Reactive Oxygen Species; D002097:C-Reactive Protein