Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-25T10:30:39.387Z Has data issue: false hasContentIssue false
  • English
  • Français

Comparison of trace element levels after cardiopulmonary bypass between cyanotic and acyanotic patients

Published online by Cambridge University Press:  07 February 2018

Firat H. Altin ,
Bahar Ozturk Kurt ,
Ibrahim C. Tanidir ,
Mehmet Kaya ,
Okan Yildiz ,
Meliha Z. Kahraman ,
Sinem B. Celebi ,
Erkut Ozturk  and
Semra Ozdemir
Firat H. Altin*
Affiliation:
Department of Pediatric Cardiovascular Surgery, Istanbul Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
Bahar Ozturk Kurt
Affiliation:
Department of Biophysics, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
Ibrahim C. Tanidir
Affiliation:
Department of Pediatric Cardiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
Mehmet Kaya
Affiliation:
Department of Pediatric Cardiovascular Surgery, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
Okan Yildiz
Affiliation:
Department of Pediatric Cardiovascular Surgery, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
Meliha Z. Kahraman
Affiliation:
Department of Anesthesiology and Reanimation, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
Sinem B. Celebi
Affiliation:
Department of Anesthesiology and Reanimation, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
Erkut Ozturk
Affiliation:
Department of Pediatric Cardiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
Semra Ozdemir
Affiliation:
Department of Biophysics, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
*
Author for correspondence: F. H. Altin, MD, Istanbul Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Selimiye Neighborhood, Tibbiye Street. No:13, Uskudar, 34668 Istanbul, Turkey. Tel: +90 533 241 16 39; Fax: +90 212 414 30 69; E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Trace elements are essential micronutrients for the human body. In this study, we evaluated the alterations in copper, chromium, manganese, selenium, magnesium, zinc, iron, arsenic, boron, and silicon levels in children with cyanotic and acyanotic CHD who underwent cardiac surgery with cardiopulmonary bypass. Participants were divided into the following three groups: patients acyanotic CHDs (n=34), patients with cyanotic CHDs (n=30), and healthy controls (n=30). Blood samples were collected before the surgery and 1 hour after the sternum was closed. Serum trace elements were determined by Inductively Coupled Plasma Optical Emission Spectrometer-ICAP 6000. The baseline serum arsenic, manganese, and zinc levels of both patient groups were lower compared with controls, but there was no significant difference between baseline serum trace element levels of cyanotic and acyanotic patients. In both the patient groups, there was a significant decrease in postoperative serum arsenic, boron, copper, and zinc levels, and a significant increase in postoperative serum iron and magnesium levels. Silicon levels increased in cyanotic patients. Alterations in trace element levels were in the same direction in cyanotic and acyanotic patients. Copper, zinc, and manganase replacement may be needed after on-pump cardiac surgery.

Keywords

Trace elementcardiac surgerycardiopulmonary bypasscyanoticacyanotic
Type
Original Articles
Information
Cardiology in the Young , Volume 28 , Issue 5 , May 2018 , pp. 632 - 638
Copyright
© Cambridge University Press 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

This study was presented in the 9th Istanbul Symposium on 24 November 2015.

References

1. Greenbaum, L. Micronutrient mineral deficiencies. In: Kliegman R, Stanton B, Behrman R, Geme J, Schor N, (eds) Nelson Textbook of Pediatrics. Elsevier Saunders, Philadelphia, PA, 2011: 343–345.Google Scholar
2. Hoashi, T, Miyata, H, Murakami, A, et al. The current trends of mortality following congenital heart surgery: the Japan Congenital Cardiovascular Surgery Database. Interact Cardiovasc Thorac Surg 2015; 21: 151–156.Google Scholar
3. Stoppe, C, Schälte, G, Rossaint, R, et al. The intraoperative decrease of selenium is associated with the postoperative development of multiorgan dysfunction in cardiac surgical patients. Crit Care Med 2011; 39: 1879–1885.CrossRefGoogle ScholarPubMed
4. Holzer, R, Bockenkamp, B, Booker, P, Newland, P, Ciotti, G, Pozzi, M. The impact of cardiopulmonary bypass on selenium status, thyroid function, and oxidative defense in children. Pediatr Cardiol 2004; 25: 522–528.Google Scholar
5. Zanoni, LZ, Melnikov, P, Consolo, LC, et al. Zinc in children undergoing cardiac surgery with cardiopulmonary bypass. Arq Bras Cardiol 2008; 90: e48–e50.Google Scholar
6. Yan, YQ, Liu, XC, Jing, WB, et al. Alteration of plasma trace elements in patients undergoing open heart surgery. Biol Trace Elem Res 2013; 151: 344–349.Google Scholar
7. Lacour-Gayet, F, Clarke, D, Jacobs, J, et al. The Aristotle score: a complexity-adjusted method to evaluate surgical results. Eur J Cardiothorac Surg 2004; 25: 911–924.Google Scholar
8. Lacour-Gayet, F, Clarke, D, Jacobs, J, et al. The Aristotle score for congenital heart surgery. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2004; 7: 185–191.Google Scholar
9. O’Brien, SM, Clarke, DR, Jacobs, JP, et al. An empirically based tool for analyzing mortality associated with congenital heart surgery. J Thorac Cardiovasc Surg 2009; 138: 1139–1153.Google Scholar
10. Jenkins, KJ. Risk adjustment for congenital heart surgery: the RACHS-1 method. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2004; 7: 180–184.CrossRefGoogle ScholarPubMed
11. Hegazi, MA. The trace elements in congenital cyanotic heart disease. Egypt Heart J 2014; 66: 25.Google Scholar
12. Litwack, G. Growth factors and cytokines. In: G. Litwack, (ed.) Human Biochemistry and Disease. Elsevier Academic Press, Pennsylvania, USA, 2008: 587–683.Google Scholar
13. Melnikov, P, Zanoni, LZ, Poppi, NR. Copper and ceruloplasmin in children undergoing heart surgery with cardiopulmonary bypass. Biol Trace Elem Res 2009; 129: 99–106.Google Scholar
14. McDonald, CI, Fung, YL, Fraser, JF. Antioxidant trace element reduction in an in vitro cardiopulmonary bypass circuit. ASAIO J 2012; 58: 217–222.Google Scholar
15. Zamparelli, R, Carelli, G, Pennisi, MA, et al. Zinc and copper metabolism during open-heart surgery. Scand J Thorac Cardiovasc Surg 1986; 20: 241–245.CrossRefGoogle ScholarPubMed
16. Davis, CM, Vincent, JB. Chromium oligopeptide activates insulin receptor tyrosine kinase activity. Biochemistry 1997; 36: 4382–4385.CrossRefGoogle ScholarPubMed
17. Rabinowitz, MB, Gonick, HC, Levin, SR, Davidson, MB. Effects of chromium and yeast supplements on carbohydrate and lipid metabolism in diabetic men. Diabetes Care 1983; 6: 319–327.CrossRefGoogle ScholarPubMed
18. Tapiero, H, Townsend, DM, Tew, KD. The antioxidant role of selenium and seleno-compounds. Biomed Pharmacother 2003; 57: 134–144.Google Scholar
19. Rayman, MP. The importance of selenium to human health. Lancet 2000; 356: 233–241.Google Scholar
20. Forceville, X, Vitoux, D, Gauzit, R, Combes, A, Lahilaire, P, Chappuis, P. Selenium, systemic immune response syndrome, sepsis, and outcome in critically ill patients. Crit Care Med 1998; 26: 1536–1544.Google Scholar
21. Manzanares, W, Biestro, A, Torre, MH, Galusso, F, Facchin, G, Hardy, G. High-dose selenium reduces ventilator-associated pneumonia and illness severity in critically ill patients with systemic inflammation. Intensive Care Med 2011; 37: 1120–1127.Google Scholar
22. Al-Bader, A, Christenson, JT, Simonet, F, Abul, H, Dashti, H, Schmuziger, M. Inflammatory response and oligo-element alterations following cardiopulmonary bypass in patients undergoing coronary artery bypass grafting. Cardiovasc Surg 1998; 6: 406–414.Google Scholar
23. Kessissoglou, DP. Manganese proteins and enzymes and relevant trinuclear synthetic complexes. Bioinorg Chem 1995; 459: 299–320.Google Scholar
24. Powell, SR. The antioxidant properties of zinc. J Nutr 2000; 130: 1447–1454.CrossRefGoogle ScholarPubMed
25. Ghaemian, A, Salehifar, E, Jalalian, R, et al. Zinc and copper levels in severe heart failure and the effects of atrial fibrillation on the zinc and copper status. Biol Trace Elem Res 2011; 143: 1239–1246.Google Scholar
26. Archer, SL. Mitochondrial dynamics-mitochondrial fission and fusion in human diseases. N Engl J Med 2013; 369: 2236–2251.Google Scholar
27. Chakraborti, S, Chakraborti, T, Mandal, M, Mandal, A, Das, S, Ghosh, S. Protective role of magnesium in cardiovascular diseases: a review. Mol Cell Biochem 2002; 238: 163–179.Google Scholar
28. Noronha, JL, Matuschak, GM. Magnesium in critical illness: metabolism, assessment, and treatment. Intensive Care Med 2002; 28: 667–679.CrossRefGoogle ScholarPubMed
29. Ying, S-Q, Fang, L, Xiang, M-X, Xu, G, Shan, J, Wang, J-A. Protective effects of magnesium against ischaemia-reperfusion injury through inhibition of P-selectin in rats. Clin Exp Pharmacol Physiol 2007; 34: 1234–1239.Google Scholar
30. Manrique, AM, Arroyo, M, Lin, Y, et al. Magnesium supplementation during cardiopulmonary bypass to prevent junctional ectopic tachycardia after pediatric cardiac surgery: a randomized controlled study. J Thorac Cardiovasc Surg 2010; 139: 162–169.CrossRefGoogle ScholarPubMed
31. Singh, RB, Manmohan, MD, Dube, KP, Singh, VP. Serum magnesium concentrations in atrial fibrillation. Acta Cardiol 1976; 31: 221–226.Google Scholar
32. DeCarli, C, Sprouse, G, LaRosa, JC. Serum magnesium levels in symptomatic atrial fibrillation and their relation to rhythm control by intravenous digoxin. Am J Cardiol 1986; 57: 956–959.Google Scholar
33. Matte, GS. Equipment for bypass. In Matte GS, (ed.) Perfusion for Congenital Heart Surgery: Notes on Cardiopulmonary Bypass for a Complex Patient Population. New Jersey, USA: John Wiley & Sons Inc. 2015: 1–27.Google Scholar
34. Jönsson, H, Johnsson, P, Bäckström, M, Alling, C, Dautovic-Bergh, C, Blomquist, S. Controversial significance of early S100B levels after cardiac surgery. BMC Neurol 2004; 4: 24.CrossRefGoogle ScholarPubMed
35. Churchwell, MD, Pasko, DA, Btaiche, IF, Jain, JC, Mueller, BA. Trace element removal during in vitro and in vivo continuous haemodialysis. Nephrol Dial Transplant 2007; 22: 2970–2977.CrossRefGoogle ScholarPubMed
36. Taggart, DP, Fraser, WD, Shenkin, A, Wheatley, DJ, Fell, GS. The effects of intraoperative hypothermia and cardiopulmonary bypass on trace metals and their protein binding ratios. Eur J Cardiothorac Surg 1990; 4: 587–594.CrossRefGoogle ScholarPubMed