Medical Physics Research Today is a free monthly online journal that collates and summarizes the latest research about Medical Physics, including details on medicine, radiotherapy, biomechanics, medical imaging. | ||||||||
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Oxidative stress during coronary artery bypass operations: importance of surgical trauma and drug treatment.Berg K, Haaverstad R, Astudillo R, Björngaard M, Skarra S, Wiseth R, Basu S, Jynge P Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway. OBJECTIVE: To investigate oxidative stress and myocardial injury at different stages of coronary artery bypass grafting (CABG). DESIGN: Twenty patients underwent CABG with use of cardiopulmonary bypass (CPB) and with intermittent sampling of plasma and urine. Main markers were: 8-iso-PGF2alpha (oxidative stress); troponin T (myocardial injury); and 15-keto-dihydro-PGF2alpha and hsCRP (inflammation). RESULTS: Plasma 8-iso-PGF2alpha increased after start of surgery, but there was no further rise during CPB or after aortic cross-clamp release and no significant myocardial arterio-venous differences. An increase in troponin T was seen early after the operation, but no relationship was established between 8-iso-PGF2alpha and troponin T. 8-iso-PGF2alpha levels were elevated by preoperative withdrawal of acetylsalicylic acid (ASA) but reduced by intraoperative use of heparin. 15-keto-dihydro-PGF2alpha was elevated during operation and hsCRP following operation. CONCLUSIONS: In the present study oxidative stress was multifactorial in origin with main impacts from surgical trauma, less from CPB and little if any from myocardial ischemia-reperfusion events. In addition, cardiovascular drugs in common use like ASA and heparin seemed to influence the pro- and antioxidant balance, a finding that has to be confirmed in future studies. Published 2 October 2006 in Scand Cardiovasc J, 40(5): 291-7.
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