Cardiopulmonary bypass exacerbates oxidative stress but does not increase proinflammatory cytokine release in patients with diabetes compared with patients without diabetes: regulatory effects of exogenous nitric oxide.

摘要: Abstract Background: Cardiopulmonary bypass induces oxidative stress and a whole-body inflammatory reaction that are believed to increase surgical morbidity. Objectives: Our goal was investigate the effect of nitric oxide supplementation on bypass-induced in patients with without diabetes undergoing elective coronary graft surgery. Methods: Patients were randomized receive an infusion saline solution or donor nitroglycerin at 1 μg · kg –1 min starting 10 minutes before initiation cardiopulmonary then maintained for 4 hours (n = per group). Serial blood samples taken various intervals plasma analyzed markers (lipid hydroperoxides, protein carbonyls, nitrotyrosine) inflammation (complement C3a, elastase, interleukin 8, tumor necrosis factor α). Results: significantly increased lipid nitrotyrosine, complement soluble E-selectin, α both groups. Infusion reduced hydroperoxides carbonyls who have affecting levels diabetes. Nitroglycerin markedly nitrotyrosine In contrast, C3a elastase 8 Conclusions: greater than those diabetes, is qualitatively different 2 groups patients. addition, reduces differentially affects response The results important implications respect use donors during bypass. (J Thorac Cardiovasc Surg 2000;120:1-11)