Effects of hyperbaric oxygen preconditioning on the postoperative oxidative stress activation in patients with TKA and THA restrictive transfusion

Objective:To study the effects of hyperbaric oxygen preconditioning on the postoperative oxidative stress activation in patients with total knee arthroplasty (TKA) and total hip arthroplasty (THA) restrictive transfusion.Methods: Patients who underwent THA and TKA and received restrictive transfusion in the Sixth Affiliated Hospital of Xinjiang Medical University and Bazhou People's Hospital of Korla between June 2014 and December 2017 were selected and divided into HBOPC group and control group according to the application of preoperative hyperbaric oxygen preconditioning or not. The contents of oxidative stress indexes in serum as well as the expression intensity of oxidative stress molecules and immune molecules in peripheral blood were determined before surgery and 24 h after surgery.Results:Compared with those of same group before surgery, serum COR, NE, AT-II, MDA and ROS contents as well as peripheral blood JNK, Akt, FoxO3a, Nrf2, ARE, Foxp3 and GATA-3 expression intensity of both groups significantly increased whereas peripheral blood CD3, CD4 and T-bet expression intensity significantly decreased, and serum COR, NE, AT-II, MDA and ROS contents as well as peripheral blood JNK, Akt, FoxO3a, Nrf2, ARE, Foxp3 and GATA-3 expression intensity of HBOPC group after surgery were lower than those of control group whereas peripheral blood CD3, CD4 and T-bet expression intensity were higher than those of control group.Conclusion: Hyperbaric oxygen preconditioning can improve the postoperative oxidative stress response activation and immune response disorder in patients with TKA and THA restrictive transfusion.