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. 2025 May 27;20(5):e0324437.
doi: 10.1371/journal.pone.0324437. eCollection 2025.

Assessment of arterial whole blood redox potential during cardiopulmonary bypass

Vincent Pey  1   2 , Marion Stephan  1   3 , Pierre Gros  3 , Cédric Dray  1 , Fanny Bounes  2 , Bertrand Marcheix  4 , Vincent Minville  1   2 , Anne Galinier  1   5 , François Labaste  1   2
Affiliations

Assessment of arterial whole blood redox potential during cardiopulmonary bypass

Vincent Pey et al. PLoS One. .

Abstract

Introduction: Imbalance in the redox equilibrium is common in any type of aggression. Cardiopulmonary bypass (CPB) initiation induces metabolic perturbations, and reliable biological monitoring tools for this condition are currently limited (e.g., lactate/pyruvate ratio). The measurement of arterial whole blood redox potential (Eredox) provides a systemic assessment of the redox state and may serve as a valuable marker for detecting metabolic perturbations during CPB. In this prospective exploratory study involving patients undergoing cardiac surgery, we investigated variations in Eredox and lactate/pyruvate ratio during CPB initiation.

Methods: Using a prospective exploratory study design, we assessed the changes in Eredox and relevant variables during the initiation of CPB in 16 cardiac surgery patients.

Results: Upon initiation of CPB we observed a significant decrease in arterial whole blood redox potential (101.90 mV + /- 11.52 vs. 41.80 mV + /- 10,26; p < 0.0001). Concomitantly, the lactate/pyruvate ratio significantly increased (12.81 + /- 0.90 vs 67.1 + /- 7.94; p < 0.0001) while the acetoacetate/β-hydroxybutyrate ratio significantly decreased (1.11 + /- 0.19 vs. 0.54 + /- 0.05 at 0 min; p = 0.0055). The circulatory failure indicated by changes in the lactate/pyruvate ratio and ketone bodies at the initiation of CPB correlated with a significant reduction in Eredox.

Conclusion: Arterial Eredox is a novel variable that holds promise in the detection and monitoring of metabolic aggression during CPB. Its assessment during CPB initiation could provide valuable insights into the patient's circulatory status, as the Eredox appears to be more sensitive than lactate for monitoring circulatory insufficiency.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Evolution of arterial redox potential during CPB.
Change in arterial redox potential (Eredox) during CPB in millivolts (mV) relative to the baseline value before CBP initiation (Pre-CPB). Mean and standard error.
Fig 2
Fig 2. Changes in lactate/pyruvate ratio and ketone bodies ratio during CPB.
L/P: Arterial lactate/pyruvate ratio. Ketone bodies ratio: acetoacetate/ß-hydroxybutyrate. CPB: cardiopulmonary bypass.
Fig 3
Fig 3. Changes in circulatory variables during CPB.
a) Variation in systolic and mean arterial pressure and heart rate during the initiation of CPB. b) Hemoglobin level (g/dL). c) StO2 variation from baseline (Pre-CBP) measured by near-infrared spectroscopy d) Variations in DO2 (oxygen transportation) et VO2 (oxygen consumption) after CEC initiation; mean and standard error.
See this image and copyright information in PMC

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