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ULTIMO FASCICOLOTHE JOURNAL OF CARDIOVASCULAR SURGERY

Rivista di Chirurgia Cardiaca, Vascolare e Toracica


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The Journal of Cardiovascular Surgery 1999 Ottobre;40(5):653-7

CARDIAC PAPERS 

 ORIGINAL ARTICLES

Red ­blood ­cell ener­gy metab­olism dur­ing car­di­o­pul­mo­nary ­bypass

Cav­a­liere F., Meo F., Sca­pig­li­a­ti A., Sciar­ra M., Schi­a­vel­lo R.

From the Department of Anesthesiology and Resuscitation Catholic University of the Sacred Heart, Rome, Italy

Background. During car­di­o­pul­mo­na­ry ­bypass (CPB) an intra­cel­lu­lar ATP def­i­cit ­could theo­ret­i­cal­ly ­play a ­role in chang­es of eryth­ro­cyte ­shape and deform­abil­ity ­caused by mechan­i­cal trau­ma. We there­fore stud­ied eryth­ro­cyte ener­gy metab­olism in 12 ­patients under­go­ing nor­mo­ther­mic CPB for myo­car­dial revas­cu­lar­iza­tion.
Methods. Blood sam­ples ­were col­lect­ed ­prior to and 45 min­utes ­after CPB begin­ning and ana­lyzed for eryth­ro­cyte ATP, ADP, and AMP and ­their metab­olites, eryth­ro­cyte NAD and ­NADP, plas­ma and ­whole ­blood lac­tate (Lactp and Lactb respec­tive­ly), and ­whole ­blood pyru­vate (Pyrb).
Results. Values ­were ­expressed as ­mean±stan­dard devi­a­tion or ­median (low­er and high­er quar­tiles) on the ­ground of a ­test for nor­mal­ity. During CPB eryth­ro­cyte nucle­o­tides and ­their metab­olites did not ­change sig­nif­i­cant­ly (ATP: 60.2±12.1 vs 68.3±13.0; ADP: 12.2±3.6 vs 12.0±3.1; AMP: 0.43±24 vs 0.44±0.26; aden­o­sine: 0.063 (0.034-0.203) vs 0.77 (0.032-0.221); ­inosine: 0.064 (0.023-0.072) vs 0.075 (0.025-0.111); hypox­an­thine: 0.330±0.272 vs 0.367±0.223; xan­thine: 0.193±0.090 vs 0.220±0.095; NAD: 3.149±0.743 vs 3.358±0.851; val­ues in µM/mM ­packed red ­blood ­cell hemo­glo­bin) ­while ­NADP ­increased (2.110±0.390 vs 2.433±0.288 µM/mM ­packed red ­blood ­cell hemo­glo­bin; p<0.05). Ringer lactate, ­with ­which the extra­cor­po­real cir­cuit was ­primed, ­caused Lactp to ­increase (1.87±0.81 vs 3.27±1.15 mM/l; p<0.01). Some lac­tate ­entered eryth­roc­y­tes ­since Lactp/Lactb ­ratio did not ­change (1.09±0.25 vs 1.07±0.23) and ­some was trans­formed ­into pyru­vate ­since Pyrb ­increased [62.9 (30.3-73.3) vs 100.5 (61.0-146.9) µM/l; p<0.01]. Lactb/Pyrb ­ratio did not ­change sig­nif­i­cant­ly [22.6 (16.1-40.5) vs 27.9 (17.5-35.2)] so ­that NAD/­NADH ­ratio and, con­se­quent­ly, the ­rate of gly­col­y­sis ­were unlike­ly to ­change too.
Conclusions. Erythrocyte ener­gy metab­olism is not affect­ed by CPB, at ­least dur­ing the peri­od of ­time tak­en ­into ­account in ­this ­study.

lingua: Inglese


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