title: α-tocopherol and ascorbic acid in early postoperative period of cardiopulmonary bypass.
abstract: OBJECTIVE
  To investigate whether α-tocopherol and ascorbic acid have effect on the suppression of inflammation in the early postoperative period after open heart surgery.
  
  
  METHODS
  A total of 59 patients who had undergone cardiopulmonary bypass (CPB) in the Cardiovascular Surgery Department of a tertiary center between June 2008 and December 2008 were retrospectively investigated. The study group consisted of 34 patients (25 men, 9 women) to whom ascorbic acid (500  mg/day) and α-tocopherol (300  mg/day) were administered on the day of operation (0th day) and the first four consecutive postoperative days. In contrast, 25 controls (20 men, 5 women) received no additional anti-inflammatory medications. The two groups were compared in terms of demographics, blood parameters such as C-reactive protein (CRP) and white blood cell (WBC) count, and durations of cross-clamp and CPB.
  
  
  RESULTS
  In the control group, CRP levels were found to be increased on the first postoperative day (P < 0.001) and CRP levels were correlated with triglyceride levels on the day of operation (P = 0.009) and the first postoperative day (P = 0.021). On the second postoperative day WBC count was found to be decreased (P = 0.008) and correlated with glucose level (P < 0.005). In the study group, CRP levels were found to be inversely correlated with serum high-density lipoprotein (HDL) (P = 0.049) on the first postoperative day and directly correlated with triglyceride levels on the second postoperative day (P = 0.017). Blood glucose levels were found to be increased on the first postoperative day (P = 0.021) and a correlation was detected between WBC count on the fourth postoperative day and doses of ascorbic acid and α-tocopherol (P = 0.027).
  
  
  CONCLUSIONS
  Suppression of the systemic inflammatory response to CPB is a double-edged sword and whether this suppression aids in the attenuation of morbidity and mortality is obscure. In this respect, ascorbic acid and α-tocopherol seem to display some anti-inflammatory effect, but further studies are necessary to reveal the actual therapeutic potential and the complex mechanism related to biochemical and inflammatory parameters.
authors.affiliation: Department of Cardiovascular Surgery, Izmir Ataturk Training and Research Hospital, Izmir, Turkey.
authors.forename: Tevfik
authors.initials: T
authors.lastname: Gunes
authors.forename: Sahin
authors.initials: S
authors.lastname: Bozok
authors.forename: Mert
authors.initials: M
authors.lastname: Kestelli
authors.forename: Ismail
authors.initials: I
authors.lastname: Yurekli
authors.forename: Gokhan
authors.initials: G
authors.lastname: Ilhan
authors.forename: Berkan
authors.initials: B
authors.lastname: Ozpak
authors.forename: Mehmet
authors.initials: M
authors.lastname: Bademci
authors.forename: Barcin
authors.initials: B
authors.lastname: Ozcem
authors.forename: Aykut
authors.initials: A
authors.lastname: Sahin
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D001205:Ascorbic Acid / Q000008:administration & dosage*; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D016009:Chi-Square Distribution; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000209:etiology / Q000276:immunology / Q000517:prevention & control*; D018836:Inflammation Mediators / Q000097:blood; D007958:Leukocyte Count; D008075:Lipoproteins, HDL / Q000097:blood; D008077:Lipoproteins, LDL / Q000097:blood; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood; D024502:alpha-Tocopherol / Q000008:administration & dosage*
chemical_list: D000893:Anti-Inflammatory Agents; D015415:Biomarkers; D001786:Blood Glucose; D018836:Inflammation Mediators; D008075:Lipoproteins, HDL; D008077:Lipoproteins, LDL; D014280:Triglycerides; D002097:C-Reactive Protein; D024502:alpha-Tocopherol; D001205:Ascorbic Acid