The Effect of Vitamin A on Immunoglobulin Levels during Operations Involving Cardiopulmonary Bypass

Effect of open and closed heart surgery on the serum levels of Ig A, Ig M and Ig G were carried out in hundred patients. In sixty cases undergoing cardiopulmonary bypass (CPB) serum Ig A and Ig M levels were found to be decreased in regard to baseline values. The mean Ig G level decreased in off bypass more significantly than hemodilution. In this study the rate of regeneration of immunoglobulins during post-bypass period was also determined. At early post-bypass 8-72 hours, serum levels of Ig A, IgM and Ig G were significantly lower than their baseline concentrations. On the other hand, on late post-bypass 10-20 days, Ig A and Ig M exceeded the basaline values, while Ig G only reaching its preoperative concentration. The rate of regeneration of Ig G, however, was slower than that of Ig A and Ig M. In order to investigate the effect of vitamin A, it was administered for then days in twenty cases prior to open operations. While the baseline values of Ig A and Ig M in patients with vitamin A supplement, were higher than in those without vitamin A the baseline concentration for Ig G was almost the same. In patients with vitamin A, the serum levels of Ig A, Ig M and G firstly decreased in off bypass and then, in post-bypass period increased in a similar fashion but almost always remaining significantly above that of patients without vitamin A. In twenty cases having closed operations, three main immunoglobulin levels retained the same value. Thus, it may be concluded that operations involving CPB cause a significant quantitative decrease in the levels of Ig A, Ig M and Ig G not only off bypass but also at early postbypass period and it is possible to prevent this fall partially with use of and adjuvant such as vitamin A.