Plasma vitamin E and A changes during cardiopulmonary bypass and in the postoperative course

• Published in: Langenbeck's archives of surgery 2003-01, Vol.387 (9-10), p.372-378
• Main Authors: Schindler, Rainer, Berndt, Suliko, Schroeder, Peter, Oster, Oskar, Rave, Gerhard, Sievers, Hans-Hinrich
• Format: Article
• Language: English
• Subjects: Aged; Antioxidants - metabolism; Biomarkers - blood; C-Reactive Protein - analysis; Cardiopulmonary Bypass; Humans; Male; Middle Aged; Monitoring, Intraoperative; Postoperative Period; Predictive Value of Tests; Preoperative Care; Probability; Prognosis; Sampling Studies; Sensitivity and Specificity; Treatment Outcome; Vitamin A - blood; Vitamin A - metabolism; Vitamin E - blood; Vitamin E - metabolism
• ISSN: 1435-2443; 1435-2451
• DOI: 10.1007/s00423-002-0336-4

Cardiopulmonary bypass induces a generalized inflammatory reaction accompanied by free radical generation. Depletion of antioxidants could result and is reported for vitamin E and C. We investigated the effect of cardiopulmonary bypass on plasma concentrations of alpha-tocopherol, retinol, and biochemical variables (e.g., triacylglycerol, cholesterol, and C-reactive protein). Plasma levels of all parameters were investigated by serial sampling in ten men undergoing elective coronary artery bypass grafting. Samples were taken before, during, and up to 48 h after bypass to obtain time profiles of the laboratory indices. alpha-Tocopherol and retinol decreased during cardiopulmonary bypass when not adjusted for confounders. After adjustment for hemodilution and lipids, no significant change was noted during bypass. However, a reduction in retinol was observed 48 h postoperatively. These data indicate that vitamin E and A analysis to ascertain links to their consumption via the production of free radicals under conditions of cardiopulmonary bypass may be inappropriate. Specifically, during bypass a reduction in systemic vitamin E and A seems to be a response to changes in blood volume and liver function.