Nitrotyrosine and its role in assessing the severity of oxidative stress and predicting the incidence of early postoperative complications

Background. Currently, the incidence of complications and perioperative mortality in cardiac surgery is still higher than in general surgery. This is partly associated with the development of oxidative stress, which is regarded as excessive accumulation of reactive oxygen species and nitrogen species. There are nowadays few studies demonstrating an increase of nitrotyrosine plasma level in patients during cardiac surgery. The relationship of these changes with post-operative complications and adverse outcomes has not been studied yet. Aim. Investigation the dynamics of the nitrotyrosine plasma level in patients after cardiac surgery and the assessment of its prognostic significance in terms of the development of early postoperative complications. Methods. The prospective observational cohort study involved 28 adult patients admitted at the cardiac intensive care unit of Moscow Regional Research and Clinical Institute (Moscow, Russian Federation). The relationship of the oxidative stress severity measured by intraoperative nitrotyrosine plasma levels and the development of acute kidney injury, cardiac failure and systemic inflammatory response syndrome was studied. Results. There was no significant perioperative dynamics of nitrotyrosine plasma levels when studying this oxidative stress marker in patients undergoing cardiac surgery. The level of nitrotyrosine plasma by the end of surgery was 12.1 [9.9; 13.0] nmol/mg of protein, which was 5% higher (p>0.5) than the initial level of 11.6 [9.3; 12.2] nmol/mg of protein, and returned to 11.5 [10.9; 12.4] after the 1st postoperative day. The same perioperative dynamics occurred in the subgroups with different surgery techniques: valve surgery, сoronary artery bypass grafting with cardiopulmonary bypass and off-pump сoronary artery bypass grafting. Conclusion. The negative result achieved in the given study might suggest that there are no significant changes of the perioperative nitrotyrosine plasma level in patients undergoing cardiac surgery, as well as that there is no significant correlation between the nitrotyrosine plasma level of and the incidence of postoperative complications.Received 26 December 2016. Accepted 4 May 2017.Funding: The study was carried out within the state-funded research project “Oxidant stress in cardiac surgery: new markers-predictors of complication development and pathogenetically substantiated therapy” granted to Moscow Regional Research and Clinical Institute.Conflict of interest: The authors declare no conflict of interest.Author contributionsConceptualization, study design: V.V. Likhvantsev. Data collection and analysis: T.S. Zabelina, Yu.V. Skripkin, O.N. Ulitkina. Drafting the article: O.A. Grebenchikov, Zh.S. Philippovskaya. Critical revision of the article: O.A. Grebenchikov. Final approval of the version to be published: V.V. Likhvantsev.

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Plasma endotoxin concentrations during cardiac surgery may be related to atherosclerosis

Perfusion ◽

10.1177/026765910001500503 ◽

2000 ◽

Vol 15 (5) ◽

pp. 421-426 ◽

Cited By ~ 8

Author(s):

Vibeke Videm ◽

Jan L Svennevig ◽

Erik Fosse ◽

Brit Mohr ◽

Ansgar O Aasen

Keyword(s):

Cardiac Surgery ◽

Postoperative Complications ◽

Valve Replacement ◽

Artery Bypass ◽

Elective Cardiac Surgery ◽

Plasma Endotoxin ◽

Systemic Endotoxemia ◽

Risk Patients ◽

The Relationship ◽

Cardiac Operations

Systemic endotoxemia develops during cardiopulmonary bypass, probably due to intestinal ischaemia. Differences in endotoxaemia among various cardiac operations and the relationship between endotoxemia and postoperative complications were studied in high-risk patients. Blood samples were obtained at termination of bypass in 136 adults undergoing elective cardiac surgery. Postoperative complications were registered prospectively. Plasma endotoxin was quantified by a kinetic limulus amebocyte lysate assay. Mean endotoxin concentrations were significantly lower in patients undergoing isolated valve replacement (89 ng/l) than in patients undergoing coronary artery bypass grafting alone (234 ng/l), or combined with valve replacement (278 ng/l) or carotid artery surgery (321 ng/l) ( p < 0.05). In multivariate linear regression, only the number of grafts (0, 1-3, 4-5) was significantly correlated to endotoxin concentrations ( p < 0.0005). Endotoxin concentrations were related to development of gastrointestinal dysfunction ( p = 0.03), but not to mortality ( p = 0.24) or other complications ( p = 0.62).

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Comparison of Platelet Mass Index in On-Pump and Off-Pump Coronary Artery Bypass Surgery

The Heart Surgery Forum ◽

10.1532/hsf.2803 ◽

2020 ◽

Vol 23 (2) ◽

pp. E154-E159

Author(s):

Murat Günday ◽

Özgür Çiftçi

Keyword(s):

Cardiac Surgery ◽

Coronary Artery ◽

Postoperative Complications ◽

Coronary Artery Bypass Surgery ◽

Bypass Surgery ◽

Artery Bypass ◽

Inflammation Marker ◽

Off Pump ◽

Early Postoperative Complications ◽

Pump Coronary Artery Bypass

Introduction: Platelet mass index (PMI) is calculated by multiplying platelet count and mean platelet volume (MPV). It demonstrates platelet activation and is thought to be associated with inflammation. Its importance for cardiac surgery has not yet fully been clarified. This study investigates whether there is a difference between PMI levels after on-pump and off-pump coronary artery bypass surgery and the relationship between early postoperative complications and PMI. Method: In our hospital, 138 patients were included in the study retrospectively. The patients were divided into 2 groups: Group 1 (on-pump) with 80 patients (22 females, 58 males, mean age 61.54 ± 8.68) and Group 2 (off-pump) with 58 patients (15 females, 43 males, mean age 61.34 ± 10.04). In biochemical analysis, hemoglobin, platelet, white blood cell, and MPV values of the patients were evaluated in the biochemistry laboratory of our hospital with the blood taken preoperatively from the forearm veins and postoperatively on the first, third, and seventh days and, on average, after the first month. Results: There was a statistically significant difference between postoperative first day thrombocyte (K/µL) (P = .005), postoperative first day PMI (P = .014), postoperative first day leukocyte (K/µL) (P = .001), postoperative first day Hb (g/dL) (P = .001), postoperative third day thrombocyte (K/µL) (P = .003), postoperative third day PMI (P = .031), postoperative third day leukocyte (K/µL) (P = .004), and postoperative seventh day leukocyte (K/µL) (P = .002). There was no meaningful relationship between PMI and early postoperative complications. Conclusion: We think PMI is a more valuable indicator than MPV as an inflammation marker in cardiac surgery. In our opinion, PMI is a cheap and valuable inflammation marker that can be used in coronary surgery that can be obtained from routine hemogram test and can easily be evaluated.

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HUBUNGAN BOARD DAN KOMITE AUDIT TERHADAP MANAJEMEN LABA

Jurnal Kajian Akuntansi dan Auditing ◽

10.37301/jkaa.v0i0.5080 ◽

2010 ◽

Author(s):

Fivi Anggraini

Keyword(s):

Corporate Governance ◽

Moral Hazard ◽

Earnings Management ◽

Conflict Of Interest ◽

Significant Relationship ◽

Stock Exchange ◽

Earning Management ◽

Independent Directors ◽

Relationship Of ◽

The Relationship

Earnings management is the moral hazard problem of manager that adses because of the conflict of interest between the manager as agent and the stakeholder and the owner as principal. The behavior of earnings management will immediately influence the reported earning. The aims of this research at examining the relationship of board and audit committe to earnings management. The samples of this research is all of companies member Corporate Governance Perception Index (CGPI) in the years of 2003-2006 which were listed in Jakarta Stock Exchange. The results of this study show that (1) the proportion of independent directors on the board had not significant relationship to earning management, (2) competence of independent directors on the board had not significant relationship to earning management, (3) the size of board had significant relationship to earning management, (4) the proportion of independent directors on the audit committe had not significant relationship to earning management, and (5) competence of members of the audit committe had significant relationship to earning management.

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Preoperative endothelial dysfunction in cutaneous microcirculation is associated with postoperative organ injury after cardiac surgery using extracorporeal circulation: a prospective cohort study

Annals of Intensive Care ◽

10.1186/s13613-020-00789-y ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Stanislas Abrard ◽

Olivier Fouquet ◽

Jérémie Riou ◽

Emmanuel Rineau ◽

Pierre Abraham ◽

...

Keyword(s):

Cardiac Surgery ◽

Cohort Study ◽

Endothelial Dysfunction ◽

Postoperative Complications ◽

Sofa Score ◽

Primary Objective ◽

Laser Speckle ◽

Organ Injury ◽

Contrast Imaging ◽

The Relationship

Abstract Background Cardiac surgery is known to induce acute endothelial dysfunction, which may be central to the pathophysiology of postoperative complications. Preoperative endothelial dysfunction could also be implicated in the pathophysiology of postoperative complications after cardiac surgery. However, the relationship between preoperative endothelial function and postoperative outcomes remains unknown. The primary objective was to describe the relationship between a preoperative microcirculatory dysfunction identified by iontophoresis of acetylcholine (ACh), and postoperative organ injury in patients scheduled for cardiac surgery using cardiopulmonary bypass (CPB). Methods Sixty patients undergoing elective cardiac surgery using CPB were included in the analysis of a prospective, observational, single-center cohort study conducted from January to April 2019. Preoperative microcirculation was assessed with reactivity tests on the forearm (iontophoresis of ACh and nitroprusside). Skin blood flow was measured by laser speckle contrast imaging. Postoperative organ injury, the primary outcome, was defined as a Sequential Organ Failure Assessment score (SOFA) 48 h after surgery greater than 3. Results Organ injury at 48 h occurred in 29 cases (48.3%). Patients with postoperative organ injury (SOFA score > 3 at 48 h) had a longer time to reach the peak of preoperative iontophoresis of acetylcholine (133 s [104–156] vs 98 s [76–139] than patients without, P = 0.016), whereas endothelium-independent vasodilation to nitroprusside was similar in both groups. Beyond the proposed threshold of 105 s for time to reach the peak of preoperative endothelium-dependent vasodilation, three times more patients presented organ dysfunction at 48 h (76% vs 24% below or equal 105 s). In multivariable model, the time to reach the peak during iontophoresis of acetylcholine was an independent predictor of postoperative organ injury (odds ratio = 4.81, 95% confidence interval [1.16–19.94]; P = 0.030). Conclusions Patients who postoperatively developed organ injury (SOFA score > 3 at 48 h) had preoperatively a longer time to reach the peak of endothelium-dependent vasodilation. Trial registration Clinical-Trials.gov, NCT03631797. Registered 15 August 2018, https://clinicaltrials.gov/ct2/show/NCT03631797

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The relationship of plasma transfusion from female and male donors with outcome after cardiac surgery

Yearbook of Anesthesiology and Pain Management ◽

10.1016/j.yane.2010.12.028 ◽

2011 ◽

Vol 2011 ◽

pp. 93-94

Author(s):

G.P. Gravlee

Keyword(s):

Cardiac Surgery ◽

Plasma Transfusion ◽

Relationship Of ◽

The Relationship

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The relationship of Charlson comorbidity index and postoperative complications in elderly patients after partial or radical nephrectomy

African Journal of Urology ◽

10.1016/j.afju.2018.09.004 ◽

2018 ◽

Vol 24 (4) ◽

pp. 387-391

Author(s):

E. Becher ◽

P.García Marchiñena ◽

J. Jaunarena ◽

D. Santillán ◽

L. Pérez ◽

...

Keyword(s):

Postoperative Complications ◽

Elderly Patients ◽

Charlson Comorbidity Index ◽

Radical Nephrectomy ◽

Comorbidity Index ◽

Relationship Of ◽

The Relationship

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Adipokines: mechanisms of metabolic and behavioral disorders

Obesity and metabolism ◽

10.14341/omet9430 ◽

2018 ◽

Vol 15 (3) ◽

pp. 14-20

Author(s):

Yassine Chahirou ◽

Abdelhalim Mesfioui ◽

Ali Ouichou ◽

Aboubaker Hessni

Keyword(s):

Oxidative Stress ◽

Insulin Resistance ◽

Adipose Tissue ◽

Lipid Metabolism ◽

Behavioral Disorders ◽

Health Problems ◽

Endocrine Tissue ◽

Physiological Functions ◽

Relationship Of ◽

The Relationship

Current studies show that metabolic and behavioral disorders represent severe health problems. Several questions arise about the molecular relationship of metabolic and behavioral disorders. This review will discuss the relationship of lipid metabolism and fructose consumption accompanied by an increase in weight as well as associated disorders: hypertension, insulin-resistance, oxidative stress and depression. Adipose tissue is considered as an endocrine tissue with intense secretory activities (metabolic and inflammatory). These adipokines are responsible for an alteration of several physiological functions. In this review we will try to understand how lipogenesis that causes dyslipidemia can influence insulin resistance, hypertension, oxidative stress, depression and the relationship between these various disorders.

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The relationship between intraoperative cerebral oximetry and postoperative delirium in patients undergoing off-pump coronary artery bypass graft surgery: a retrospective study

BMC Anesthesiology ◽

10.1186/s12871-020-01180-x ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Leerang Lim ◽

Karam Nam ◽

Seohee Lee ◽

Youn Joung Cho ◽

Chan-Woo Yeom ◽

...

Keyword(s):

Cardiac Surgery ◽

Coronary Artery ◽

Postoperative Delirium ◽

Artery Bypass ◽

Bypass Graft ◽

Cerebral Oximetry ◽

Artery Bypass Graft ◽

Off Pump ◽

Pump Coronary Artery Bypass ◽

The Relationship

Abstract Background Cerebral oximetry has been widely used to measure regional oxygen saturation in brain tissue, especially during cardiac surgery. Despite its popularity, there have been inconsistent results on the use of cerebral oximetry during cardiac surgery, and few studies have evaluated cerebral oximetry during off pump coronary artery bypass graft surgery (OPCAB). Methods To evaluate the relationship between intraoperative cerebral oximetry and postoperative delirium in patients who underwent OPCAB, we included 1439 patients who underwent OPCAB between October 2004 and December 2016 and among them, 815 patients with sufficient data on regional cerebral oxygen saturation (rSO2) were enrolled in this study. We retrospectively analyzed perioperative variables and the reduction in rSO2 below cut-off values of 75, 70, 65, 60, 55, 50, 45, 40, and 35%. Furthermore, we evaluated the relationship between the reduction in rSO2 and postoperative delirium. Results Delirium occurred in 105 of 815 patients. In both univariable and multivariable analyses, the duration of rSO2 reduction was significantly longer in patients with delirium at cut-offs of < 50 and 45% (for every 5 min, adjusted odds ratio (OR) 1.007 [95% Confidence interval (CI) 1.001 to 1.014] and adjusted OR 1.012 [1.003 to 1.021]; p = 0.024 and 0.011, respectively). The proportion of patients with a rSO2 reduction < 45% was significantly higher among those with delirium (adjusted OR 1.737[1.064 to 2.836], p = 0.027). Conclusions In patients undergoing OPCAB, intraoperative rSO2 reduction was associated with postoperative delirium. Duration of rSO2 less than 50% was 40% longer in the patients with postoperative delirium. The cut-off value of intraoperative rSO2 that associated with postoperative delirium was 50% for the total patient population and 55% for the patients younger than 68 years.

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