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Author Spotlight: Innovating Thiol Quantification and Biomarker Detection for Oxidative Stress Research
Published on: June 28, 2024
Glutathione Blood Concentrations: A Biomarker of Oxidative Damage Protection during Cardiopulmonary Bypass in
Angela Satriano1, Simone Franchini2, Giuseppe Lapergola2
1Department of Pediatric Cardiac Surgery, IRCCS San Donato Milanese Hospital, San Donato Milanese, 20097 Milan, Italy.
Insights
Blood glutathione (GSH) levels increase after pediatric heart surgery, indicating a response to oxidative stress. Monitoring GSH may help optimize cardiopulmonary bypass (CPB) during surgery for children with congenital heart disease.
Area of Science:
- Biochemistry
- Pediatric Cardiology
- Surgical Research
Background:
- Pediatric open-heart surgery using cardiopulmonary bypass (CPB) carries significant risks.
- Current monitoring lacks parameters to assess perioperative stress effectively.
Purpose of the Study:
- To investigate changes in blood glutathione (GSH) levels during pediatric open-heart surgery.
- To determine if GSH can serve as a biomarker for perioperative stress in these patients.
Main Methods:
- An observational study involving 35 children with congenital heart disease (CHD).
- Assessed standard laboratory parameters and blood GSH levels at five perioperative time points.
Main Results:
- GSH levels progressively increased from pre-surgery to 24 hours post-surgery, peaking at CPB completion.
- GSH levels at CPB completion correlated with CPB duration, cross-clamping time, arterial oxygen partial pressure, and body core temperature.
Conclusions:
- Elevated GSH suggests a compensatory response to oxidative damage during surgery.
- Highlights the need for careful management of CPB, particularly reoxygenation, in vulnerable pediatric patients.
- GSH monitoring may guide optimal temperature and oxygenation targets during CPB.
Background:
Pediatric open-heart surgery with cardiopulmonary bypass (CPB) still remains a risky interventional procedure at high mortality/morbidity. To date, there are no clinical, laboratory, and/or monitoring parameters providing useful information on perioperative stress. We therefore investigated whether blood concentrations of glutathione (GSH), a powerful endogenous antioxidant, changed in the perioperative period.
Methods:
We conducted an observational study in 35 congenital heart disease (CHD) children in whom perioperative standard laboratory and monitoring parameters and GSH blood levels were assessed at five monitoring time points.
Results:
GSH showed a pattern characterized by a progressive increase from pre-surgery up to 24 h after surgery, reaching its highest peak at the end of CPB. GSH measured at the end of CPB correlated with CPB duration, cross-clamping, arterial oxygen partial pressure, and with body core temperature.
Conclusions:
The increase in GSH levels in the perioperative period suggests a compensatory mechanism to oxidative damage during surgical procedure. Caution is needed in controlling different CPB phases, especially systemic reoxygenation in a population that is per se more prone to oxidative stress/damage. The findings may point the way to detecting the optimal temperature and oxygenation target by biomarker monitoring.
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