Home > Journals > The Journal of Cardiovascular Surgery > Past Issues > The Journal of Cardiovascular Surgery 1999 February;40(1) > The Journal of Cardiovascular Surgery 1999 February;40(1):65-9

CURRENT ISSUE
 

JOURNAL TOOLS

Publishing options
eTOC
To subscribe
Submit an article
Recommend to your librarian
 

ARTICLE TOOLS

Reprints
Permissions
Share

 

ORIGINAL ARTICLES  CARDIAC PAPERS 

The Journal of Cardiovascular Surgery 1999 February;40(1):65-9

Copyright © 2000 EDIZIONI MINERVA MEDICA

language: English

Plasma hypoxanthine levels during crystalloid and blood cardioplegias: Warm blood cardioplegia increases hypoxanthine levels with a greater risk of oxidative stress

Quinlan G. J., Westerman S. T., Mumby S., Pepper J. R., Cutteridge J. M. C.

From the * Departments of Cardiothoracic Surgery and Anaesthesia and Adult Intensive Care Royal Brompton Hospital National Heart and Lung Institute Imperial College of Science Technology and Medicine London, UK


PDF


Back­ground. ­Patients under­going car­di­o­pul­mo­nary ­bypass (CPB) are sub­jected to ­severe oxi­da­tive ­stress, and fre­quently ­show evi­dence of ­acute ­lung ­injury ­post sur­gery. Asso­ci­a­tions ­between ­acute ­lung ­injury, oxi­da­tive ­stress, and aber­rant ATP catab­o­lism ­have ­been ­made and ­prompted us to con­sider ­whether the ­purine metab­olites xan­thine and hypox­an­thine ­alter sig­nif­i­cantly ­during CPB ­when dif­ferent ­types of car­di­o­plegia are ­used.
Methods. Experi­mental ­design: ret­ro­spec­tive ­follow up ­study on ­stored ­plasma sam­ples ­from ­patients ran­domly ­selected to ­receive ­either ­warm ­blood, ­cold ­blood, or crys­tal­loid car­di­o­plegia. Set­ting: ­adult inten­sive ­care ­unit of ­post grad­uate ­teaching hos­pital. ­Patients: ­thirty-­eight ­patients under­going ­aortic ­valve replace­ment, ­with or ­without ­artery ­grafting. Oper­a­tion was car­ried out by a ­single sur­geon. Inter­ven­tions: all ­patients ­received ­either a homo­graft ­aortic ­valve or a stent­less por­cine ­valve.
­Results. No sig­nif­i­cant dif­fer­ences in xan­thine ­levels at any ­time ­points ­during CPB, or ­between the dif­ferent car­di­o­plegic ­groups. Hypox­an­thine ­levels ­were, how­ever, sig­nif­i­cantly ­higher in ­patients ­receiving ­warm ­blood car­di­o­plegia (74.84±16.715 µM, p=0.0151), and was ­most ­marked at ­time ­point 3 ­when the ­aortic ­cross ­clamp was ­released. ­Patients ­receiving crys­tal­loid car­di­o­plegia ­showed ­higher ­levels of hypox­an­thine (44.56±10.16 µM) ­than ­those ­receiving ­cold ­blood car­di­o­plegia (21.57±7.106 µM).
Con­clu­sions. Con­sid­ering ­these ­data ­together, it sug­gests ­that aber­rant ATP catab­o­lism, char­ac­ter­istic of ­ischaemia/reper­fu­sion, is fur­ther dis­turbed ­during ­warm ­blood car­di­o­plegia ­leading to a ­marked ­increase in ­plasma hypox­an­thine ­levels. ­This has the poten­tial to fur­ther ­increase oxi­da­tive ­stress ­during CPB.

top of page