Observation of parameters of organ damage, inflammation, and oxidative stress in patients undergoing open-heart surgery during cardiopulmonary bypass with oxygen tension controlled at 60 and 170 mmHg

LIU Lei; LI Zhaobin; LI Bin; XU Guanjie; WANG Yuanyuan; SONG Wanjun

doi:10.3969/j.issn.1002-266X.2017.31.006

Abstract：Objective To compare the parameter changes of organ damage, inflammation, and oxidative stress in patients undergoing open-heart surgery during cardiopulmonary bypass with oxygen tension controlled at 60 and 170 mmHg.Methods Eighty patients undergoing open-heart surgery were randomly divided into the low oxygen tension group and high oxygen tension group with 40 patients in each.The oxygen tension in the low oxygen tension group and high oxygen tension group was 60 mmHg and 170 mmHg, respectively.The plasma was collected before surgery and at 30 min, 2 h, 6 h, 24 h after aortic declamping (T0-T4).The levels of glutamic-pyruvic transaminase (ALT), glutamic oxalacetic transaminase (AST), alkaline phosphatase (ALP), creatinine (Cr), urea nitrogen (UN), uric acid (UA) in the plasma were measured by fully automatic biochemical analyser;the levels of cardiac troponin (cTnI), creatine kinase isoenzyme (CK-MB), C-reactive protein (CRP), interleukin 6 (IL-6), tumor necrosis factor-α (TNF-α) in the plasma were measured by ELISA;reactive oxygen (ROS), malonaldehyde (MDA) in the plasma were measured by kits.Results The levels of cTnI, CK-MB, ALT, AST, ALP, Cr, UN, and UA in the plasma of both groups increased significantly at T1-T4 as compared with those of the same group at T0 (all P<0.05);compared with the high oxygen tension group, the levels of cTnI, CK-MB, AST, ALT, ALP, Cr, UN, and UA in the low oxygen tension group at T2-T4 decreased significantly (all P<0.05).The levels of CRP, TNF-α and IL-6 increased significantly at T1-T4 as compared with those of the same group at T0 (all P<0.05);compared with the high oxygen tension group, the levels of CRP, TNF-α and IL-6 in the low oxygen tension group at T1-T4 decreased significantly (all P<0.05).The levels of ROS and MDA in both groups at T1-T4 increased significantly as compared with those of the same group at T0 (all P<0.05);compared with the high oxygen tension group, the levels of ROS and MDA in the low oxygen tension group at T1-T4 decreased significantly (all P<0.05).Conclusion Compared with the high oxygen tension, using low oxygen tension during CPB in open-heart surgery can reduce CPB-induced organ damage, inflammation, and oxidative stress significantly.