Effect of the Duration of Cardiopulmonary Bypass on Oxidative Stress and Metabolic Activity of Erythrocytes and Their Correction by Nitric Oxide

The aim of this study was to investigate lipid peroxidation processes and the metabolic parameters of erythrocytes in patients who underwent cardiac surgery, depending on the duration of cardiopulmonary bypass (CPB). The intensity of lipoperoxidation and the state of erythrocyte metabolism were assessed at different stages of surgery and postoperatively. The results demonstrated that during CPB, there was an increase in oxidative processes and a decrease in organic phosphates within erythrocytes, correlated with the duration of CPB. Under the influence of nitric oxide, a reduction in malondialdehyde levels and an increase in catalase activity in erythrocytes were observed. The application of nitric oxide led to a twofold increase in ATP concentration and a 1.5-fold increase depending on the duration of CPB. Nitric oxide supplied to the extracorporeal circuit exerted an antioxidant effect regardless of CPB duration. Importantly, during prolonged CPB, NO promoted an increase in erythrocyte ATP levels, which is critical for flow-mediated vasodilation and regional blood flow enhancement. Studying the effect of nitric oxide through stimulation of ATP production and export represents a promising approach to understanding NO's role in cardiac surgery under CPB conditions.