Decreased antioxidant status and increased lipid peroxidation in patients with septic shock and secondary organ dysfunction

Goode, Helen F.; Cowley, Hugh; Walker, B. E.; Howdle, P D; Webster, Nigel R.

doi:10.1097/00003246-199504000-00011

Cited by 426 publications

(269 citation statements)

References 20 publications

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“…The pathophysiological role of severe oxidative stress reactions in SIRS has been demonstrated by experimental and clinical studies, in which an increase in measured oxidative stress markers are directly associated with a decrease in serum antioxidants (5,20). In our study, we highlighted that increased levels of 8-OHdG/Creatinine as an oxidative stress marker correlated with increased levels of PCT, CRP and WBC.…”

Section: Discussionsupporting

confidence: 58%

The Effectiveness of Tocotrienol Rich Fraction and Αlpha Tocoferol with Combination of Vitamin C in The Management of Systemic Inflammatory Response Syndrome (SIRS)

Ye¹,

Rahman²,

Mz³

et al. 2017

JSA

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The pathophysiology of systemic inflammatory response syndrome (SIRS) had been described to involve various strong oxidative reactions affecting the status and progress of the patients. Antioxidant therapy had been suggested in many studies involving SIRS management. The objective of this study was to compare the role of vitamin E Tocotrienol and vitamin E Tocopherol combined with vitamin C as antioxidant therapy in the management of critically ill patients diagnosed with SIRS, admitted to the intensive care unit and high dependency wards of Universiti Kebangsaan Malaysia Medical Centre (UKMMC). It was a single blind randomized clinical trial with a total of 72 patients in which 44.4% Malays, 34.7% Chinese, 19.4% Indians and 1.4% others with 59.7% males and 40.3% females were recruited. Patients in TRI E group received Tocotrienol with Vitamin C while TOCO group received Tocopherol with Vitamin C and a control group did not receive any antioxidant. The clinical parameters (heart rate, respiratory rate, systolic blood pressure) showed improvements with significant difference at the end of study (post-intervention) as compared to admission (pre-intervention).Whereas, the sepsis (temperature, PCT, CRP and WBC) and oxidative stress (8-OHdG/Creatinine) parameters showed improvements with significant difference at the end of study (post-intervention) as compared to admission (pre-intervention). The TRI E group showed obvious improvement in clinical, sepsis and oxidative stress parameters, as compared to TOCO and control groups. This study showed that Vitamin E Tocotrienol and Vitamin E Tocopherol in combination with Vitamin C demonstrated significant improvement in the clinical and laboratory parameters during the management of SIRS. Therefore, Vitamin E in combination with Vitamin C had therapeutic benefits in the treatment of critically ill patients with SIRS.

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Section: Discussionsupporting

confidence: 58%

The Effectiveness of Tocotrienol Rich Fraction and Αlpha Tocoferol with Combination of Vitamin C in The Management of Systemic Inflammatory Response Syndrome (SIRS)

Ye¹,

Rahman²,

Mz³

et al. 2017

JSA

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“…The most seriously ill patients in intensive care units (ICUs) have increased mediators of oxidant stress and a higher incidence of multiorgan failure than less seriously ill patients. [1][2][3][4][5] Meta-analyses of randomized trials suggest that glutamine and antioxidant supplementation in critically ill patients may be associated with improved survival. 6,7 However, recent large studies have not confirmed such an effect.…”

Section: Resultsmentioning

confidence: 99%

A Randomized Trial of Glutamine and Antioxidants in Critically Ill Patients

Heyland

Muscedere

Wischmeyer

et al. 2014

Survey of Anesthesiology

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“…Furthermore, albumin has an antioxidant effect, 40,41 and it is well known that oxidative stress is an important feature in the pathogenesis of sepsis. 42 We do not have an explanation for the second question.…”

Section: Discussionmentioning

confidence: 95%

Systemic, renal, and hepatic hemodynamic derangement in cirrhotic patients with spontaneous bacterial peritonitis

et al. 2003

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Spontaneous bacterial peritonitis (SBP) is frequently associated with renal failure. This study assessed if systemic and hepatic hemodynamics are also affected by this condition. Standard laboratory tests, tumor necrosis factor ␣ (TNF-␣) in plasma and ascitic fluid, plasma renin activity (PRA) and norepinephrine (NE), and systemic and hepatic hemodynamics were determined in 23 patients with SBP at diagnosis and after resolution of infection. Eight patients developed renal failure during treatment. At diagnosis of infection, patients developing renal failure showed significantly higher values of TNF-␣, blood urea nitrogen (BUN), PRA and NE, peripheral vascular resistance, and hepatic venous pressure gradient (HVPG) and lower cardiac output than patients not developing renal failure. During treatment, a significant reduction in cardiac output and arterial pressure and increase in PRA and NE, HVPG, and Child-Pugh score were observed in the first group but not in the second. Peripheral vascular resistance remained unmodified in both groups. Changes in PRA and NE correlated inversely with changes in arterial pressure and directly with changes in BUN, Child-Pugh score, and HVPG. Five patients in the renal failure group developed encephalopathy, and 6 died. In the group without renal failure, none of the patients developed encephalopathy or expired. In conclusion, patients with SBP frequently develop a rapidly progressive impairment in systemic hemodynamics, leading to severe renal and hepatic failure, aggravation of portal hypertension, encephalopathy, and death. This occurs despite rapid resolution of infection and is associated with an extremely poor prognosis.

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Decreased antioxidant status and increased lipid peroxidation in patients with septic shock and secondary organ dysfunction

Abstract: These data indicate decreased antioxidant status in the face of enhanced free radical activity, and suggest potential therapeutic strategies involving antioxidant repletion.

Cited by 426 publications

References 20 publications

The Effectiveness of Tocotrienol Rich Fraction and Αlpha Tocoferol with Combination of Vitamin C in The Management of Systemic Inflammatory Response Syndrome (SIRS)

The Effectiveness of Tocotrienol Rich Fraction and Αlpha Tocoferol with Combination of Vitamin C in The Management of Systemic Inflammatory Response Syndrome (SIRS)

A Randomized Trial of Glutamine and Antioxidants in Critically Ill Patients

Systemic, renal, and hepatic hemodynamic derangement in cirrhotic patients with spontaneous bacterial peritonitis

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