Systemic consequences of oxidative stress following aortic surgery correlate with the degree of antioxidant defenses

The purpose of this study was to correlate the preoperative level of antiox idant defenses, measured by the plasma total antioxidant capacity (TAC), to the degree of postoperative systemic inflammatory response, measured by th e severity of pulmonary injury following elective aortic surgery. Twenty-fo ur patients had TAC measured preoperatively and 24 hr postoperatively. Ches t radiography and arterial blood gases were obtained preoperatively and ser ially during the first 24 hr after surgery. Using objective radiologic crit eria and blood gas analysis, the degree of pulmonary edema and pulmonary dy sfunction were quantified. All patients showed evidence of pulmonary dysfun ction in the first 24 hr following surgery. Fifteen of the 24 patients show ed radiographic evidence of noncardiogenic pulmonary edema in the immediate postoperative period. In this group, the TAC was lower than in those witho ut pulmonary edema immediately following surgery (p = 0.03). Preoperative T AC was associated with the degree of pulmonary edema in the postoperative p eriod (r = -0.372, p = 0.067). These results suggest that preoperative anti oxidant supplementation may favorably impact the severity of systemic infla mmatory response following ischemia and reperfusion injury. DOI: 10.1007/s1 00169910006.