Prime solutions for cardiopulmonary bypass in neonates: Antioxidant capacity of prime based on albumin or fresh frozen plasma

Objective: Oxidative damage and inflammation are believed to play an import ant role in postoperative complications after cardiopulmonary bypass. Durin g bypass, a prime solution with a high antioxidant capacity may reduce the oxidative damage and inflammation. We investigated total antioxidant capaci ty and individual scavengers during the preparation of 2 different prime so lutions. Methods: The prime solutions were prepared with either pasteurized human al bumin or fresh frozen plasma. The total antioxidant capacity was measured w ith the total radical antioxidant parameter assay and with the ferric-reduc ing ability of plasma assay. The individual scavengers vitamin C, sulfhydry l groups, uric acid, and total protein were measured before, during, and af ter the prime preparation. Malondialdehyde was measured as a parameter for lipid peroxidation. Results: Neither prime solution showed a total radical antioxidant paramete r value. The ferric-reducing ability of plasma value of prime solutions was lower than that of undiluted human albumin or fresh frozen plasma. Additio n of mannitol did not increase the ferric-reducing ability of plasma value. Vitamin C was only found in the fresh frozen plasma prime. Both prime solu tions contained sulfhydryl groups and uric acid in low concentrations. Duri ng ultrafiltration, low-molecular-weight antioxidants were lost into the ul trafiltrate. Conclusions: We showed that prime solutions based on either albumin or fres h frozen plasma had very low antioxidant capacity and that ultrafiltration of the prime solution further lowers this capacity. A prime solution with a low antioxidant capacity may increase oxidative stress in neonates undergo ing cardiopulmonary bypass.