Probiotic supplementation and postoperative antioxidant response in patients undergoing open‑heart surgery: a randomized controlled trial.

Overview

This randomized controlled trial investigated the effects of probiotic supplementation on oxidative stress biomarkers in patients undergoing open-heart surgery. Oxidative stress represents a significant contributor to postoperative complications in cardiac surgery patients, and probiotics have been proposed as potential modulators of antioxidant defenses through mechanisms involving gut microbiota modulation and reduction of systemic inflammation. The study enrolled 37 patients with cardiovascular disease scheduled for open-heart surgery, randomly allocating 18 to receive probiotic supplementation and 19 to receive placebo. The intervention period spanned from one day preoperatively through two weeks postoperatively, with measurement of plasma malondialdehyde and total antioxidant capacity as primary outcome measures.

Methods and approach

The trial design incorporated a placebo-controlled structure with intervention initiation one day prior to surgical procedures. Probiotic supplementation continued for a two-week postoperative period in the intervention cohort, while the control group received matching placebo treatment over the same timeframe. Oxidative stress assessment utilized plasma malondialdehyde as a marker of lipid peroxidation and total antioxidant capacity as an indicator of overall antioxidant defense status. Measurement protocols employed enzyme-linked immunosorbent assay methodology for malondialdehyde quantification and colorimetric methods for total antioxidant capacity determination. Baseline measurements were obtained prior to intervention initiation, with follow-up assessments conducted at the conclusion of the two-week intervention period.

Key Findings

The intervention group demonstrated a statistically significant increase in total antioxidant capacity from 221.52 ± 24.68 to 356.23 ± 34.57, whereas the control group exhibited a decrease from 220.73 ± 14.12 to 209.68 ± 14.83, with statistical significance indicated by F = 15.794. This divergent pattern between groups suggests differential modulation of antioxidant defense capacity associated with probiotic administration. The magnitude of change in total antioxidant capacity in the intervention group exceeded 60 percent from baseline values, representing a substantial enhancement of antioxidant status during the critical postoperative period. The control group's decline in total antioxidant capacity aligns with expected postoperative oxidative stress responses in the absence of adjunctive interventions.

Implications

The findings indicate that probiotic supplementation may enhance postoperative antioxidant defenses in cardiac surgery patients, potentially offering an adjunctive therapeutic approach to mitigate oxidative stress-related complications. The observed improvement in total antioxidant capacity suggests mechanisms involving gut microbiota modulation and inflammatory pathway regulation may contribute to systemic antioxidant enhancement. However, the study acknowledges limitations inherent to the sample size of 37 patients and calls for larger-scale investigations to validate these preliminary findings and establish clinical significance. The perioperative timing of probiotic administration, beginning one day preoperatively, may represent a practical intervention window for implementation in clinical cardiac surgery protocols, though optimization of dosing regimens and strain selection requires further investigation.