Bacground/Aim. Using omega-3 polyunsaturated fatty acids (PUFAs) in coronary
artery bypass graft surgery (CABG) could provide protection against
ischemicreperfusion damage, prevention of postoperative arrhythmia and
attenuation of inflammatory response. However, omega-3 PUFAs inhibit
cyclooxygenase (and thus decrease the synthesis of thromboxane A2 from
arachidonic acid in platelets), which leads to decreased platelet
aggregation. In cardiac surgery it is necessary to achieve a balance between
inhibition and full platelets function. It is as well as important to
closely follow hematological parameters, impaired by CABG itself. Therefore,
the aim of the study was to establish the effects of pretreatment with
omega- PUFAs on hematological parameters and plateletes aggregation in
patients with elective CABG. Methods. This prospective, randomized,
placebo-controlled, single-center trial was performed on parallel groups.
The patients (n = 40) undergoing elective CABG were randomized receiving
preoperative intravenous omega-3 PUFAs (Omegaven? 10%) infusion (the PUFAs
group) or the same volume of 0.9% saline solution infusion (the control
group). Infusion was given a day before surgery and repeated four hours
before starting extracorporeal circulation (CPB) via the peripheral vein at
single doses of 100 mL (25 mL/h). Platelet function analysis was performed
using multiple electrode aggregometry (MEA, multiplate-analyzer) before
starting CPB and 2 h postoperatively for the patients of both groups.
Results. There were no clinically relevant differences in baseline
characteristics between the groups. Hematological parameters were not
significantly different between the groups pre-, intra- and postoperatively.
During the first 24 h after surgery, the loss of blood was similar in the
PUFAs and the control group (680 ? 274 mL and 608 ? 210 mL, respectively; p
= 0.356). Postoperatively, platelet aggregation was not significantly
different between the PUFAs and the control group in adenosine diphosphate
(ADP) test (39 ? 11 and 42 ? 15, respectively; p = 0.701), arachidonic acid
(ASPI) test (64 ? 24 and 70 ? 27, respectively; p = 0.525) and trombin
receptor-activating peptide (TRAP) test (68 ? 25 and 75 ? 26, respectively;
p = 0.396), while their aggregation in collagen (COL) test was statistically
significantly lower in the PUFAs related to the control group (32 ? 15 and
47 ? 20, respectively; p = 0.009). Conclusion. Acute pretreatment with
omega-3 PUFAs insignificantly affected the activity of platelets and did not
influence postoperative blood loss.
Effect of pretreatment with omega-3 polyunsaturated fatty acids (PUFAs) on hematological parameters and platelets aggregation in patients during elective coronary artery bypass grafting