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Oxidative stress markers are not associated with outcomes after pediatric heart surgery
Paulo H Manso1, Fabio Carmona, Felipe Dal-Pizzol
1Division of Pediatric Cardiology, Hospital das Clínicas, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil. phmanso@uol.com.br
Insights
Perioperative serum levels of oxidative stress markers, thiobarbituric acid reactive substances (TBARS) and carbonyl moieties, were not associated with outcomes like low cardiac output syndrome or mortality in children undergoing heart surgery with cardiopulmonary bypass.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Surgery
- Biomarkers
- Oxidative Stress
Background:
- Oxidative stress markers increase after heart surgery with cardiopulmonary bypass (CPB).
- These markers may contribute to ischemia-reperfusion injury.
- Associations with myocardial dysfunction, low cardiac output syndrome (LCOS), and clinical outcomes remain unproven.
Purpose of the Study:
- To investigate the association between perioperative serum oxidative stress markers (TBARS and carbonyl moieties) and outcomes in pediatric heart surgery patients.
- To determine if these markers predict LCOS, mortality, or hospital length of stay.
Main Methods:
- Retrospective analysis of 55 children undergoing heart surgery.
- Comparison of pre-, intra-, and postoperative serum levels of TBARS and carbonyl moieties.
- Analysis of associations with LCOS, cyanotic/acyanotic congenital heart disease (CHD), survival, and adjusted hospital length of stay (aLOS).
Main Results:
- Serum TBARS and carbonyl moieties levels did not significantly change over time.
- No significant differences in marker levels were found between patients with or without LCOS, cyanotic/acyanotic CHD, or survivors/nonsurvivors.
- Peak TBARS levels correlated with peak tumor necrosis factor alpha (TNF-α) levels, but neither marker was independently associated with aLOS.
Conclusions:
- Perioperative serum TBARS and carbonyl moieties are not associated with LCOS development in children after heart surgery.
- These oxidative stress markers do not predict adjusted hospital length of stay or mortality in this population.
- The role of these specific oxidative stress markers in pediatric cardiac surgery outcomes requires further investigation.
Objectives:
To investigate whether perioperative serum levels of oxidative stress markers, thiobarbituric acid reactive substances (TBARS), and carbonyl moieties are associated with outcomes in children after heart surgery.
Background:
Oxidative stress markers are increased following heart surgery with cardiopulmonary bypass (CPB) and can play a role in ischemia-reperfusion injury, but its associations with myocardial dysfunction, low cardiac output syndrome (LCOS), and outcomes are not proven.
Methods:
In a retrospective secondary analysis of a cohort study comprising 55 children (median age, 109 [2-611] days), we compared pre-, intra- and postoperative serum levels of TBARS and carbonyl moieties among patients with and without postoperative LCOS, cyanotic and acyanotic congenital heart disease (CHD), and survivors and nonsurvivors. We also assessed the independent effect of TBARS and carbonyl moieties peak levels on the mortality-adjusted hospital length of stay (aLOS).
Results:
Patients who developed postoperative LCOS (n = 36) were significantly younger, more frequently cyanotic, more severely ill, and underwent more complex procedures with longer CPB. However, TBARS and carbonyl moieties serum levels did not change significantly over time. Moreover, they were not significantly different in patients with or without LCOS, cyanotic and acyanotic CHD, or survivors and nonsurvivors. There was a significant correlation between TBARS and tumor necrosis factor alpha (TNF-α) peak serum levels. Neither TBARS nor carbonyl moieties peak serum levels were independently associated with aLOS.
Conclusions:
In conclusion, oxidative stress markers TBARS and carbonyl moieties were not associated with the development of LCOS, the aLOS, or mortality in children after heart surgery with CPB.
