Influence of cardiopulmonary bypass on the erythrocyte membranes and the method of its protection

V.І. Cherniy; L.O.  Sobanska; P.O.  Topolov; T.V.  Сherniy

doi:10.26641/2307-0404.2021.1.227936

Authors

V.І. Cherniy State Institution of Science "Research and Practical Center of Preventive and Clinical Medicine" State Administrative Department Scientific, Department of Minimally Invasive Surgery, Verkhnia str., 5, Kyiv, 01014, Ukraine, Ukraine https://orcid.org/0000-0002-9885-9248
L.O. Sobanska State Institution of Science "Research and Practical Center of Preventive and Clinical Medicine" State Administrative, Department Scientific, Department of Minimally Invasive Surgery, Verkhnia str., 5, Kyiv, 01014, Ukraine, Ukraine https://orcid.org/0000-0002-0162-0442
P.O. Topolov State Institution of Science "Research and Practical Center of Preventive and Clinical Medicine" State Administrative Department, Scientific Department of Minimally Invasive Surgery, Verkhnia str., 5, Kyiv, 01014, Ukrain, Ukraine https://orcid.org/0000-0002-4423-9297
T.V. Сherniy State Institution of Science "Research and Practical Center of Preventive and Clinical Medicine" State Administrative Department, Scientific Department of Minimally Invasive Surgery, Verkhnia str., 5, Kyiv, 01014, Ukraine, Ukraine https://orcid.org/0000-0002-0095-6091

DOI:

https://doi.org/10.26641/2307-0404.2021.1.227936

Keywords:

fructose-1.6-diphosphate, cardiopulmonary bypass, erythrocyte, hemolysis, mechanical resistance, osmotic resistance, acid hemolysis, erythrocyte membrane permeability, phosphorus

Abstract

The damage to erythrocytes during cardiopulmonary bypass (CPB) remains a recent problem. The aim of this research was to study the effect of fructose-1,6-diphosphate on the state of the erythrocyte membrane during CPB and the level of phosphorus in blood as a marker of the energy potential in the cell. Patients were divided into two groups. The control group 1 (Gr 1) consisted of 75 individuals. The group 2 (Gr 2) included patients to whom fructose-1,6-diphosphate (FDP) was administrated according to the developed scheme as follows 10 g of the drug was diluted in 50 ml of a solvent, 5 g of the drug was injected intravenously with the use of perfusor immediately before initiation of CPB at a rate of 10 ml/min and 5 g at the 30th minute of CPB (before the stage of warming) the same way. When comparing two groups the best results in hemolysis (p<0.01), mechanical (p<0.01). osmotic resistance of erythrocytes (p<0.01), the time of acid hemolysis (p<0.01) and the permeability of the erythrocyte membrane in postperfusion period were in Gr 2. Вefore cardiac surgery hypophosphatemia was detected in 18% out of 150 and in 32% out of 150 patients – a lower limit of normal phosphorus content in the blood. After CPB in Gr 1 phosphorus content in blood was 0.85±0.32 mmol/l and hypophosphatemia was in 53% out of 75 patients. This indicates a pronounced energy deficit in this group. In Gr 2 phosphorus level was 1.7±0.31 mmol/l and there was no hypophosphatemia. As a result, FDP as an endogenous high-energy intermediate metabolite of the glycolytic pathway leads to resistance to hemolysis, protects the erythrocyte membrane from damage and increases the energy potential of the cell during CPB.

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