The effect of various operative techniques during the myocardial surgical revascularisation to an oxidative stress and antioxidative protection

Cilj. Osnovni cilj studije je utvrditi razlike izmeĊu vrednosti pokazatelja oksidativno-stresnog statusa kod bolesnika kojima hirurška revaskularizacija miokarda uraĊena na kucajućem srcu (Off-Pump Coronary Artery Bypass-OPCAB grupa) i bolesnika kojima je revaskularizacija miokarda uraĊena uz pomoć pumpe za vantelesnu cirkulaciju (Cardio-Pulmonary Bypass pump-CPB grupa). Da bi se ostvario osnovni cilj, bilo je potrebno odrediti koncentracije markera oksidativnog stresa-prooksidanasa ili produkata njihovog delovanja na biomolekule, kao i koncentracije ĉinilaca antioksidativne zaštite kod dve grupe bolesnika. TakoĊe, jedan od bitnih ciljeva studije je bio ispitati da li postoji korelacija izmeĊu vremena provedenog na respiratoru, broja dana provedenih na odeljenju intezivne nege, broja dana provedenih u bolnici nakon operacije, broja jedinica primenjene transfuzije krvi, smanjenja telesne teţine nakon operacije (kg), broja bolniĉkih infekcija, kao i brzine i kvaliteta oporavka u obe grupe bolesnika. Jedna od glavnih ideja studije je bila sagledavanje biohemijskih pokazatelja oksidativnog stresa u svetlu kliniĉkih parametara kod OPCAB hirurgije, kao i primena rezultata ove studije u svakodnevnoj kliniĉkoj praksi. Sa tim u vezi, osnovna ideja i koncept studije su bili vezani za reevaluaciju indikacija kod hirurške revaskularizacije miokarda u smislu svakodnevne rutinske primene OPCAB procedura, kao metode izbora. Materijal i metode. Istraţivanje je sprovedeno u vidu kohortne studije, koja je obuhvatila 107 bolesnika podvrgnutih hirurškoj revaskularizaciji miokarda. Bolesnici su bili podeljeni u dve grupe (CPB i OPCAB grupa). U prvoj grupi bolesnika, kojima je revaskularizacija miokarda uraĊena uz pomoć pumpe za vantelesnu cirkulaciju (CPB grupa), je bilo 60 bolesnika. U drugoj grupi bolesnika, kojima je revaskularizacija miokarda uraĊena na kucajućem srcu, je bilo 47 bolesnika...Objective. The main objective of the study is to determine the difference between the value of the oxidative stress status indicators in patients whom surgical revascularization was performed on the beating heart (Off-Pump Coronary Artery Bypass-OPCAB group) and patients who underwent revascularization with the help of pumps for artificial circulation (Cardio-Pulmonary Bypass pump-CPB group). In order to achieve the main objective, it was necessary to determine the concentrations of markers of oxidative stress-prooxidants or products of their action on biomolecules, as well as the concentration of antioxidant protection factors in two groups of patients. Also, one of the essential objectives of the study was to examine whether there is a correlation between the time spent on a ventilator, the number of days spent on the intensive care unit, the number of days spent in the hospital after the surgery, the number of units applied blood transfusion, weight loss after surgery (kg ), the number of hospital infections, as well as the speed and quality of recovery in both groups of patients. One of the main ideas of the study was assessment of biochemical indicators of oxidative stress in the terms of clinical parameters in OPCAB surgery, as well as the application of the results of this study in everyday clinical practice. In this regard, the basic idea and the concept of the study were related to the re-evaluation of indications in coronary artery bypass surgery in terms of the everyday routine application of OPCAB procedures, as a method of choice. Materials and Methods. The study was carry out in the form of cohort study, which included 107 patients undergoing surgical myocardial revascularization..