Oxidative stress due to anesthesia and surgical trauma: Importance of early enteral nutrition

Abstract

Anesthesia and surgical trauma are considered major oxidative and nitrosative stress effectors resulting in the development of SIRS. In this study we evaluated the usefulness of early enteral nutrition after surgical trauma. Sixty male Wistar rats were subjected to midline laparotomy and feeding-gastrostomy. Twenty of these rats served as controls after recovering from the operation stress. The remaining rats received, through gastrostomy, enteral nutrition or placebo-feeding for 24 h. Oxidative stress markers and CC chemokine production were evaluated in rat serum and liver tissue. The operation itself was found to increase nitric oxide (NO) and malondialdehyde (MDA) and to decrease superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px), as well as liver tissue energy charge (EC) in relation to controls. The rats receiving enteral feeding exhibited statistically significantly lower levels of NO and MDA, and higher levels of SOD, GSH-Px, and liver EC, in relation to placebo feeding rats. The operation significantly increased the chemokines monocyte chemoattractant protein (MCP)-1 and regulated upon activation, normal T-cell expressed, and secreted (RANTES) in rat serum, while enteral nutrition caused a further significant increase in chemokine levels in serum. mRNA chemokine expression in liver was increased in a similar pattern. These findings indicate that early enteral feeding might play an important role after surgery ameliorating oxidative stress, affecting positively the hepatic EC and regulating, via chemokine production, cell trafficking, and healing process.

Early Enteral Nutrition and Outcomes of Critically Ill Patients Treated With Vasopressors and Mechanical Ventilation

“…7 Other favorable effects of enteral nutrition include better substrate utilization, prevention of mucosal atrophy, preservation of the integrity of gut flora, and preservation of immunocompetence. [8][9][10][11][12][13][14][15][16] Early enteral feeding can also ameliorate oxidative stress after surgery 17 and can decrease postoperative mortality in patients who have gastrointestinal surgery. 18 Therefore, physicians have become interested in feeding patients as soon as possible.…”

Increased oxidative stress status in rat serum after five minutes treadmill exercise

“…First of all, the usage of pentobarbital as an anesthetic before the killing of the animals, considering that this reagent was previously suggested to influence the levels of some oxidative stress markers [40,41]. However, pentobarbital was injected in both our study groups (the sedentary and the exercised one).…”

Hypolipidemic effects of different angiocarp parts ofAlpinia zerumbet

“…Enteral nutrition supply after surgery or phytoantioxidant therapy under stress may promptly recover or activate levels of antioxidative SOD and GPX (Li et al, 2009). Similarly, in hyperlipidemia, levels of in vivo ROS are usually increased (Kotzampassi et al, 2009), resulting in tremendous oxidative damage in a diversity of organs and tissues. Apparently, the induction of SOD and GPX could be significant in balancing such in vivo oxidative stresses.…”

“…Mammals are reported to be able to synthesize arachidonic acid from linoleic acid (Garrett & Grisham, 1995). Stress effectors usually are able to suppress levels of superoxide dismutase (SOD) and glutathione peroxidase (GPX) (Kotzampassi et al, 2009). Enteral nutrition supply after surgery or phytoantioxidant therapy under stress may recover or re-activate these two antioxidative enzyme levels (Li et al, 2009).…”