title: Oxidative stress markers are not associated with outcomes after pediatric heart surgery.
abstract: OBJECTIVE
  To investigate whether perioperative serum levels of oxidative stress markers, thiobarbituric acid reactive substances (TBARS), and carbonyl moieties are associated with outcomes in children after heart surgery.
  
  
  BACKGROUND
  Oxidative stress markers are increased following heart surgery with cardiopulmonary bypass (CPB) and can play a role in ischemia-reperfusion injury, but its associations with myocardial dysfunction, low cardiac output syndrome (LCOS), and outcomes are not proven.
  
  
  METHODS
  In a retrospective secondary analysis of a cohort study comprising 55 children (median age, 109 [2-611] days), we compared pre-, intra- and postoperative serum levels of TBARS and carbonyl moieties among patients with and without postoperative LCOS, cyanotic and acyanotic congenital heart disease (CHD), and survivors and nonsurvivors. We also assessed the independent effect of TBARS and carbonyl moieties peak levels on the mortality-adjusted hospital length of stay (aLOS).
  
  
  RESULTS
  Patients who developed postoperative LCOS (n = 36) were significantly younger, more frequently cyanotic, more severely ill, and underwent more complex procedures with longer CPB. However, TBARS and carbonyl moieties serum levels did not change significantly over time. Moreover, they were not significantly different in patients with or without LCOS, cyanotic and acyanotic CHD, or survivors and nonsurvivors. There was a significant correlation between TBARS and tumor necrosis factor alpha (TNF-α) peak serum levels. Neither TBARS nor carbonyl moieties peak serum levels were independently associated with aLOS.
  
  
  CONCLUSIONS
  In conclusion, oxidative stress markers TBARS and carbonyl moieties were not associated with the development of LCOS, the aLOS, or mortality in children after heart surgery with CPB.
authors.affiliation: Division of Pediatric Cardiology, Hospital das Clínicas, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil. phmanso@uol.com.br
authors.forename: Paulo H
authors.initials: PH
authors.lastname: Manso
authors.forename: Fabio
authors.initials: F
authors.lastname: Carmona
authors.forename: Felipe
authors.initials: F
authors.lastname: Dal-Pizzol
authors.forename: Fabrícia
authors.initials: F
authors.lastname: Petronilho
authors.forename: Fabíola
authors.initials: F
authors.lastname: Cardoso
authors.forename: Margaret
authors.initials: M
authors.lastname: Castro
authors.forename: Ana P C P
authors.initials: AP
authors.lastname: Carlotti
mesh_terms: D000758:Anesthesia; D015415:Biomarkers / Q000032:analysis*; D002303:Cardiac Output, Low / Q000150:complications; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D015331:Cohort Studies; D003490:Cyanosis / Q000150:complications; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay; D008297:Male; D015428:Myocardial Reperfusion Injury / Q000150:complications; D018384:Oxidative Stress / Q000502:physiology*; D011183:Postoperative Complications / Q000453:epidemiology; D016016:Proportional Hazards Models; D050050:Protein Carbonylation; D012189:Retrospective Studies; D017392:Thiobarbituric Acid Reactive Substances / Q000032:analysis; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D017392:Thiobarbituric Acid Reactive Substances