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Hemolysis compromises nitric oxide-dependent vasodilatory responses in patients undergoing major cardiovascular surgery.
- Source :
-
The Thoracic and cardiovascular surgeon [Thorac Cardiovasc Surg] 2012 Jun; Vol. 60 (4), pp. 255-61. Date of Electronic Publication: 2012 Mar 12. - Publication Year :
- 2012
-
Abstract
- Background: The hemolytic products cell-free oxyhemoglobin (FHb) and arginase-1 reduce nitric oxide (NO) bioavailability by scavenging NO and by degrading the NO precursor arginine to ornithine, respectively. In this study we evaluated the relevance of hemolysis to NO-dependent blood flow in patients undergoing cardiovascular surgery.<br />Methods: Plasma FHb, arginase-1, and amino acid concentrations were measured perioperatively. Forearm blood flow (FBF) responses to the intra-arterial administered NO-donor sodium nitroprusside (SNP) and the endothelium-dependent vasodilator acetylcholine (ACh) were measured by venous occlusion plethysmography.<br />Results: When peak values plasma FHb and arginase-1 were found, vascular dilatation to SNP, but not ACh, was significantly reduced compared with 1 day postoperatively, when FHb had returned to baseline levels (p < 0.05). Interestingly, plasma FHb concentration was inversely correlated to FBF responses to SNP (r -0.93, p < 0.001). In contrast, the increase in arginase-1 was not biologically relevant as the ratio of plasma arginine to ornithine remained constant.<br />Conclusion: We conclude that hemolysis with concomitant release of FHb during cardiovascular surgery is associated with impaired NO-dependent forearm blood flow.<br /> (Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.)
- Subjects :
- Acetylcholine administration & dosage
Aged
Analysis of Variance
Arginase blood
Arginine blood
Biomarkers blood
Female
Humans
Injections, Intra-Arterial
Male
Netherlands
Nitric Oxide Donors administration & dosage
Nitric Oxide Donors metabolism
Nitroprusside administration & dosage
Nitroprusside metabolism
Ornithine blood
Oxyhemoglobins metabolism
Plethysmography
Time Factors
Vasodilator Agents administration & dosage
Vasodilator Agents metabolism
Aortic Aneurysm, Thoracic surgery
Forearm blood supply
Hemolysis
Nitric Oxide metabolism
Vascular Surgical Procedures adverse effects
Vasodilation drug effects
Subjects
Details
- Language :
- English
- ISSN :
- 1439-1902
- Volume :
- 60
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- The Thoracic and cardiovascular surgeon
- Publication Type :
- Academic Journal
- Accession number :
- 22411759
- Full Text :
- https://doi.org/10.1055/s-0031-1299571