The relationship between oxidative stress and serum albumin in early postoperative period

SUMMARYPostoperative oxidative stress and antioxidant capacity plays an important role inpostoperative mortality and morbidity in a surgical patient ?Ebb? phase; the postoperative earlyphase; is generally characterized with a over all energy mobilization and lasts around 24 hours. Themeans and the capacity of the patients in encountering such a stress in the posttraumatic period isstill not totally verified and is contradictory.The aim of the present study is to evaluate the effects ofpostoperative oxidative stress in ?ebb? phase in patients with elective major operations on serumalbumin which is one of the major antioxidant cemical in bodily fluids. 32 patients with stage 4 and27 patients with stage 5 operations according to the POSSUM scoring system were included in thestudy. The metabolic and hormonal responce to trauma and the POSSUM physiologic and operativeevaluation were compared among the two groups .The two group were statistically insignificantinterms of mean age, body mass index and POSSUM physiologic scores. Nevertheless; in bothgroups the postoperative changes in cortisol, LDH, glucose and hsCRP levels were statisticallysignificant when compared to the individual preoperative levels . Furthermore; when stage 4 andstage 5 operations were compared interms of metabolic and hormonal responce no statisticaldifference was obtained ; which is highly suggestive that patients with similar POSSUM physiologicscores give similar responces to surgical trauma. Stage 4 and 5 patients showed a statisticallysignificant difference interms serum total protein and albumin in the pre-and postoperative period.On the other hand postoperative homocystein was significantly different among the twogroups.Cystein 34 redox active thiol group in Albumin is 80% of the mechanisms in the plasmaencountering a continous oxidative assault. In stage 4 and 5 patients although an major differenceinterms of the severity of the operative trauma exists; no diffrence in the metabolic and homonalresponce in the postoperative period could be found. This suggests that the major factor determiningthe responce to operative taruma and oxidative stress in the early postoperative period is the serumalbumin and homocystein levels in the patients. One of the reasons in increased mortality andmorbidity in stage 5 patients with respect to the stage 4 patients may be explained with the extensionof the oxidative assault beyond the limits of the oxidative capacity