The Beneficial Effects of Antioxidant Supplementation in Enteral Feeding in Critically Ill Patients: A Prospective, Randomized, Double-Blind, Placebo-Controlled Trial

Abstract

We investigated whether intervention with antioxidant vitamins C and E in enteral feeding influenced oxidative stress and clinical outcome in critically ill patients. Two-hundred-sixteen patients expected to require at least 10 days of enteral feeding completed the study. One-hundred-five patients received enteral feeding supplemented with antioxidants, and 111 control patients received an isocaloric formula. Plasma lipoperoxidation (by thiobarbituric acid reactive substances [TBARS] and prostaglandin F(2alpha) isoprostane levels), low-density lipoprotein (LDL) oxidizability, and LDL tocopherol content were determined at baseline and at the end of the 10-day period. The clinical 28-day outcome was also assessed. Plasma TBARS and isoprostanes were 5.33 +/- 1.26 nM/mL and 312 +/- 68 pg/mL, respectively, before treatment and 2.42 +/- 0.61 nM/mL and 198 +/- 42 pg/mL after intervention (P < 0.01 for both comparisons). Antioxidants improved LDL resistance to oxidative stress by approximately 30% (the lag time before treatment was 87 +/- 23 min and was 118 +/- 20 min after treatment; P < 0.04). There was a significantly reduced 28-day mortality after antioxidant intervention (45.7% in the antioxidant group and 67.5% in the regular-feeding group; P < 0.05). Isoprostanes may provide a sensitive biochemical marker for dose selection in studies involving antioxidants.

Micronutrients: do small things matter?

“…31 The systematic review and meta-analysis undertaken by our group 31 substantially builds on the initial very important review by Heyland et al 9 by including seven new trials, including the first four multi-centre randomised controlled trials in this area of research. [32][33][34][35] This updated review 31 indicates and supports previous findings 9 that micronutrient supplementation in the critically ill may be associated with a reduction in overall mortality, and specifically 28 day mortality.…”

Suppression Effect of Superoxide Dismutase (SOD)-Like Activity Protein Partially Purified from &lt;i&gt;Raphnus sativus&lt;/i&gt; Leaves against Liver Metastasis in Mice Intraperitoneally Infected with Ehrlich Ascites Carcinoma Cell

“…The present study suggests that, Raphnus sativus partial purified protein with SOD-like activity may be one of the treatment strategies. Ben Salah-Abbès, reported that, the extract of radishcontains many antioxidant compounds that protect against the toxicity resulting from mycotoxin (Zearalenone) [36] [37].…”

The role of endothelin-1 and new therapeutic approaches in sepsis and septic shock

“…Sepsis sırasında erken dönemde oluşan oksidatif streste nötrofiller, makrofajlar, endotel hücre-leri rol almakta ve immün sistemin ilk savunma mekanizması olarak patojene karşı savaşmaktadır. Patojen tarafından etkinleştirilen bu hücreler reaktif oksijen türlerinin (ROT) üretiminde artışa neden olmaktadır (30)(31)(32)(33)(34)(35)(36). Septik şok gibi doku kanlanmasının azaldığı durumlarda endoteliyumdan vazoaktif maddeler salıverilmektedir.…”