title: Carbon dioxide pneumoperitoneum induces systemic oxidative stress: a clinical study.
abstract: OBJECTIVE
  To investigate the effect of carbon dioxide pneumoperitoneum on systemic oxidative stress by using serum oxidative stress markers (ischemia modified albumin (IMA), malondialdehyde (MDA), total oxidant status (TOS), total antioxidant status (TAS) and oxidative stress index (OSI)) and to compare their effectiveness at clinically accepted safe intra-abdominal pressure levels (<12 mmHg).
  
  
  METHODS
  A total of 33 consecutive patients who had a unilateral ovarian cyst were enrolled for this prospective clinical study. All women underwent a laparoscopic ovarian cystectomy procedure. Venous blood was collected from patients preoperatively, 10 min after induction of anesthesia and 30 min after insufflation. Preoperative, 10(min), and 30(min) serum IMA, MDA, TOS, OSI and TAS levels were compared.
  
  
  RESULTS
  The mean age was 29.3 ± 6.4 and the range of operation time was 45-80 min. The mean serum IMA levels showed a significant increase 30 min later from CO(2) insufflation (p<0.05). Significant alterations were not observed in serum MDA, TOS, OSI or TAS levels.
  
  
  CONCLUSIONS
  Laparoscopic surgery causes systemic ischemia and this ischemic effect can be revealed by measuring serum ischemia modified albumin. IMA is more sensitive than MDA, TOS, OSI and TAS in early detection of systemic oxidative stress.
authors.affiliation: Department of Obstetrics and Gynecology, Karadeniz Technical University, Trabzon, Turkey.
authors.forename: Turhan
authors.initials: T
authors.lastname: Aran
authors.forename: Mesut A
authors.initials: MA
authors.lastname: Unsal
authors.forename: Suleyman
authors.initials: S
authors.lastname: Guven
authors.forename: Cavit
authors.initials: C
authors.lastname: Kart
authors.forename: Esra Can
authors.initials: EC
authors.lastname: Cetin
authors.forename: Ahmet
authors.initials: A
authors.lastname: Alver
mesh_terms: D000328:Adult; D000975:Antioxidants; D015415:Biomarkers / Q000097:blood; D002245:Carbon Dioxide; D005260:Female; D006801:Humans; D007327:Insufflation; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D008315:Malondialdehyde / Q000097:blood; D016877:Oxidants / Q000097:blood; D018384:Oxidative Stress; D011028:Pneumoperitoneum, Artificial / Q000009:adverse effects*; D012709:Serum Albumin; D000075462:Serum Albumin, Human
chemical_list: D000975:Antioxidants; D015415:Biomarkers; D016877:Oxidants; D012709:Serum Albumin; C561522:ischemia-modified albumin; D002245:Carbon Dioxide; D008315:Malondialdehyde; D000075462:Serum Albumin, Human