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Open AccessArticle

Glutathione Blood Concentrations: A Biomarker of Oxidative Damage Protection during Cardiopulmonary Bypass in Children

Department of Pediatric Cardiac Surgery, IRCCS San Donato Milanese Hospital, San Donato Milanese, 20097 Milan, Italy
Neonatal Intensive Care Unit, G. d’Annunzio University of Chieti, 65100 Chieti, Italy
Department of Biomedical and Biotechnological Sciences Section of Biochemistry University of Catania, 95100 Catania, Italy
AO SS Antonio, Biagio and C. Arrigo Hospital Alessandria, 15121 Alessandria, Italy
Author to whom correspondence should be addressed.
Diagnostics 2019, 9(3), 118;
Received: 24 July 2019 / Revised: 29 August 2019 / Accepted: 10 September 2019 / Published: 13 September 2019
(This article belongs to the Special Issue Diagnosis and Management of Pediatric Diseases)
Background. Pediatric open-heart surgery with cardiopulmonary bypass (CPB) still remains a risky interventional procedure at high mortality/morbidity. To date, there are no clinical, laboratory, and/or monitoring parameters providing useful information on perioperative stress. We therefore investigated whether blood concentrations of glutathione (GSH), a powerful endogenous antioxidant, changed in the perioperative period. Methods. We conducted an observational study in 35 congenital heart disease (CHD) children in whom perioperative standard laboratory and monitoring parameters and GSH blood levels were assessed at five monitoring time points. Results. GSH showed a pattern characterized by a progressive increase from pre-surgery up to 24 h after surgery, reaching its highest peak at the end of CPB. GSH measured at the end of CPB correlated with CPB duration, cross-clamping, arterial oxygen partial pressure, and with body core temperature. Conclusions. The increase in GSH levels in the perioperative period suggests a compensatory mechanism to oxidative damage during surgical procedure. Caution is needed in controlling different CPB phases, especially systemic reoxygenation in a population that is per se more prone to oxidative stress/damage. The findings may point the way to detecting the optimal temperature and oxygenation target by biomarker monitoring. View Full-Text
Keywords: GSH; cardiopulmonary bypass; newborn; brain damage; oxidative stress GSH; cardiopulmonary bypass; newborn; brain damage; oxidative stress
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Satriano, A.; Franchini, S.; Lapergola, G.; Pluchinotta, F.; Anastasia, L.; Baryshnikova, E.; Livolti, G.; Gazzolo, D. Glutathione Blood Concentrations: A Biomarker of Oxidative Damage Protection during Cardiopulmonary Bypass in Children. Diagnostics 2019, 9, 118.

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