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[Mannitol reduces plasma hydrogen peroxide free radical in patients undergoing coronary artery bypass graft surgery]
1Department of Anesthesiology, Veterans General Hospital-Taipei, Taiwan, R.O.C.
Insights
Mannitol effectively scavenges free oxygen radicals during coronary artery bypass graft (CABG) surgery. This intervention significantly reduces hydrogen peroxide [H2O2] levels, mitigating potential cardiac damage post-operation.
Area of Science:
- Cardiovascular Surgery
- Biochemistry
- Free Radical Biology
Context:
- Coronary artery bypass graft (CABG) surgery can lead to myocardial damage due to ischemia-reperfusion injury.
- Free oxygen radicals, particularly hydrogen peroxide [H2O2], play a significant role in post-operative cardiac dysfunction and arrhythmias.
- Existing treatments for ischemia-reperfusion injury include various chemical agents, but their efficacy requires further evaluation.
Purpose:
- To evaluate the efficacy of mannitol as a free oxygen radical scavenger in patients undergoing CABG surgery.
- To measure the concentration of hydrogen peroxide [H2O2], a marker of free radical activity, before and after CABG.
- To determine if mannitol administration alters [H2O2] levels during the procedure.
Summary:
- This study investigated mannitol's role in mitigating free radical damage during CABG.
- Patients received either mannitol (experimental group) or no treatment (control group).
- Hydrogen peroxide [H2O2] levels were measured using mass spectrophotometry, revealing a statistically significant reduction in the mannitol group post-operatively compared to the control.
Impact:
- Mannitol demonstrates considerable efficacy as a free oxygen radical scavenger in CABG patients.
- Reducing [H2O2] production with mannitol may help improve cardiac function and reduce post-operative complications.
- This finding supports the use of mannitol as a therapeutic agent to protect the myocardium during cardiac surgery.
Abstract:
During the procedure of coronary artery bypass graft surgery (CABG), the release of free oxygen radicals as a result of ischemia and reperfusion which plants the seeds of post-operative low cardiac output and arrhythmias has grave consequence on the reestablishment of cardiac function. A variety of chemical agents such as mannitol, allopurinol, catalase (Q-10) and superoxide dismutase (SOD) has proved to be considerably effective to improve the myocardial necrosis following ischemia and reperfusion. In this study we chose mannitol (0.2 gm/kg) as the free oxygen radicals scavenger and utilized mass spectrophotometric method to detect the variation of concentration of [H2O2], a by-product of free oxygen radical, in an attempt to evaluate the efficacy of mannitol in this regard in patients undergoing CABG. Patients were divided into experimental group (n = 19) and control group (n = 20). In the experimental group the concentration of [H2O2] changed from 61 +/- 24 microM/L pre-operatively to 77 +/- 18 microM/L post-operatively as against 75 +/- 31 microM/L and 99 +/- 31 microM/L respectively in the control group. In comparison, only the change in experimental group was statistically significant (p less than 0.05). We confirmed that mannitol functions considerably as a free oxygen radical scavenger since it reduces the production of [H2O2] in patients undergoing CABG.