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Effects of Upper Limb Ischemia-Reperfusion on Regional Oxidative Stress During Aortic Surgery with Moderate Hypothermia
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  • Aslı Demir,
  • Hülya Yiğit Özay,
  • Kubra Vardar,
  • Gulsum Karduz,
  • Uğur Aksu,
  • Ertekin Unal,
  • Ayşegül Özgök
Ankara City Hospital
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Aslı Demir
Ankara City Hospital
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Hülya Yiğit Özay
Ankara City Hospital
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Kubra Vardar
Istanbul University
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Gulsum Karduz
Istanbul University
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Uğur Aksu
Istanbul Universitesi
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Ertekin Unal
Ankara City Hospital
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Ayşegül Özgök
Ankara City Hospital
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INTRODUCTION: The aim of this study is to evaluate the effect of acute, iatrogenic right arm ischemia and reperfusion on microcirculation using tissue perfusion markers like central venous oxygen saturation, lactate, the difference between central venous and arterial CO2 pressure, Near-infrared spectroscopy, and biomarkers like sialic acid, malondialdehyde, advanced oxidative protein products in aortic surgery with moderate hypothermia. METHODS: Adult patients undergoing ascending aorta repair with antegrade cerebral perfusion via axillary artery participated in the study. Blood samples were collected from the radial artery, internal juguler vein, right arm cubital vein and left arm cubital vein and analysis were performed at five intraoperative time points. Blood samples for biomarkers were obtained at three intraoperative time points. RESULTS: Right arm venous oxygen saturation are significantly lower than left arm and central venous. Right arm lactate levels are significantly higher than left arm and central venous lactate levels. Somatic right arm near-infrared spectroscopy values are significantly lower than somatic left arm. There are no significant differences for biomarkers throughout the time points. CONCLUSIONS: We have concluded that well-known markers such as central venous oxygen saturation and lactate reflect the results of ischemia-reperfusion faster, and are more valuable than novel biomarkers. Near-infrared spectroscopy is a promising monitor in terms of providing information about tissue oxygenation. However, oxidative stress biomarkers seem to be far from following the results of ischemia-reperfusion damage in an instant or short time, moreover, their costs are high and laboratory studies take time.

Peer review status:ACCEPTED

20 Jul 2020Submitted to Journal of Cardiac Surgery
23 Jul 2020Submission Checks Completed
23 Jul 2020Assigned to Editor
12 Aug 2020Reviewer(s) Assigned
11 Nov 2020Review(s) Completed, Editorial Evaluation Pending
15 Nov 2020Editorial Decision: Revise Major
13 Dec 20201st Revision Received
15 Dec 2020Assigned to Editor
15 Dec 2020Submission Checks Completed
16 Dec 2020Reviewer(s) Assigned
16 Dec 2020Review(s) Completed, Editorial Evaluation Pending
28 Dec 2020Editorial Decision: Revise Major
05 Jan 20212nd Revision Received
05 Jan 2021Submission Checks Completed
05 Jan 2021Assigned to Editor
06 Jan 2021Reviewer(s) Assigned
22 Jan 2021Review(s) Completed, Editorial Evaluation Pending
29 Jan 2021Editorial Decision: Accept