Background and objective: The purpose of the study was to evaluate oxidative stress and liver monooxygenase function in patients with coronary heart disease and multiple organ dysfunction syndrome.
Methods: Twenty-seven patients with multiple organ dysfunction and 38 patients with an uneventful postoperative period were studied. Oxidative stress was quantified with malon dialdehyde, coupled trienes, hepatocuprein and catalase activity. Liver monooxygenase function was evaluated with antipyrine pharmacokinetics data.
Results: On the first postoperative day patients with multiple organ dysfunction were characterized by high lipid peroxidation (conjugated trienes: +84.7%) and significant decrease in liver monooxygenase function (clearance of antipyrine: -38%), whereas control patients had a mild oxidative stress and a slight depression in liver monooxygenase function. On the third to fourth postoperative day in both groups a considerable intensity of lipid peroxidation and increase in liver metabolism was seen. The major difference was observed on postoperative days 10-12. In both groups oxidative stress intensity decreased (conjugated trienes: +34.7%; +12.9%). In the main group liver monooxygenase function was markedly depressed (clearance of antipyrine: -35.6%), whereas in the control group liver metabolism did not deviate from the baseline. The correlation analysis showed a negative relationship between liver monooxygenase function and oxidative stress parameters.
Conclusion: Patients with multiple organ dysfunction have considerably more oxidative stress and greater decrease in liver monooxygenase function (one and a half times) than those with an uneventful postoperative period. Lipid peroxidation is one of the main causes of depression of liver monooxygenase function. Slowdown of liver metabolism might change the pharmacokinetic response in patients with coronary heart disease.