Abstract
Objective:Hidden blood loss (HBL), commonly seen after total knee or hip arthroplasty, causes postoperative anemia even after reinfusion or blood transfusion based on the visible blood loss volume. Recent studies demonstrated that oxidative stress might be involved in HBL. However, whether the antioxidants proanthocyanidin (PA) or hydrogen water (HW) can ameliorate HBL remains poorly understood. The aim of this study was to evaluate the effects of PA and HW on HBL.Materials and Methods:A rat HBL model was established through administration of linoleic acid with or without treatment with PA or HW. The levels of hemoglobin (Hb), red blood cell (RBC) count, superoxide dismutase (SOD) activity, glutathione peroxidase (GSH-PX) activity, malondialdehyde (MDA), and ferryl Hb were measured.Results:RBC and Hb values as well as the activity of SOD and GSHPX were reduced after administration of linoleic acid, which was ameliorated by treatment with PA or HW. In addition, the quantity of MDA was significantly decreased with the administration of PA or HW.Conclusion:PA and HW could ameliorate HBL in a rat model by reducing oxidative stress, suggesting that they might be used as a novel therapeutic approach in the prophylaxis or treatment of HBL in clinics.
Highlights
Artificial joint replacements are widely employed to alleviate pain and improve the quality of patients’ lives [1]
red blood cells (RBCs) and Hb values as well as the activity of superoxide dismutase (SOD) and GSHPX were reduced after administration of linoleic acid, which was ameliorated by treatment with PA or hydrogen water (HW)
PA and HW could ameliorate Hidden blood loss (HBL) in a rat model by reducing oxidative stress, suggesting that they might be used as a novel therapeutic approach in the prophylaxis or treatment of HBL in clinics
Summary
Artificial joint replacements are widely employed to alleviate pain and improve the quality of patients’ lives [1]. Hidden blood loss (HBL) predominantly occurs after artificial joint replacement, such as in cases of TKA and THA [3]. A recent study demonstrated that free fatty acids (FFAs) generated from fatty emboli in the blood circulation are responsible for HBL through peroxidation injury of membrane molecules of red blood cells (RBCs) and hemoglobin (Hb) [4]. Antioxidants administered intra- or postoperatively are predicted to play a protective role in erythrocyte oxidation and potentially reduce the volume of HBL after arthroplasty, suggesting that oxidation might be involved in the pathogenesis of HBL. ROS play a physiological role in preventing cells from experiencing oxidative stress [11]. Considering the role of oxidative stress in the pathogenesis of HBL, whether PA and/or HW as antioxidants ameliorate HBL remains poorly understood. The objective of this study was to evaluate the effect of PA and HW on HBL as well as to compare their protective effects by measuring the levels of Hb, RBC count, superoxide dismutase (SOD), glutathione peroxidase (GSH-PX), malondialdehyde (MDA), and ferryl Hb
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