Blood markers of oxidative stress predict weaning failure from mechanical ventilation

Journal of Cellular and Molecular Medicine

Cléber Verona¹  Fernanda S. Hackenhaar¹  Cassiano Teixeira³  Tássia M. Medeiros¹  Paulo V. Alabarse¹  Tiago B. Salomon¹  Ártur K. Shüller¹  Juçara G. Maccari³  Robledo Leal Condessa²  Roselaine P. Oliveira³  Silvia R. Rios Vieira² 

[1] Biophysics Department, Program of Cellular and Molecular Biology, Federal University of Rio Grande do Sul, Rio Grande do Sul, Brazil;Clínicas Hospital of Porto Alegre, Rio Grande do Sul, Brazil;Department of Critical Care, Moinhos de Vento Hospital, Rio Grande do Sul, Brazil

关键词: Oxidative stress;    intensive care units;    weaning;    mechanical ventilation;    malondialdehyde;    nitric oxide;    vitamin C;   

DOI  :  10.1111/jcmm.12475

来源: Wiley

【 摘 要 】

Abstract

Patients undergoing mechanical ventilation (MV) often experience respiratory muscle dysfunction, which complicates the weaning process. There is no simple means to predict or diagnose respiratory muscle dysfunction because diagnosis depends on measurements in muscle diaphragmatic fibre. As oxidative stress is a key mechanism contributing to MV-induced respiratory muscle dysfunction, the aim of this study was to determine if differences in blood measures of oxidative stress in patients who had success and failure in a spontaneous breathing trial (SBT) could be used to predict the outcome of MV. This was a prospective analysis of MV-dependent patients (≥72 hrs; n = 34) undergoing a standard weaning protocol. Clinical, laboratory and oxidative stress analyses were performed. Measurements were made on blood samples taken at three time-points: immediately before the trial, 30 min. into the trial in weaning success (WS) patients, or immediately before return to MV in weaning failure (WF) patients, and 6 hrs after the trial. We found that blood measures of oxidative stress distinguished patients who would experience WF from patients who would experience WS. Before SBT, WF patients presented higher oxidative damage in lipids and higher antioxidant levels and decreased nitric oxide concentrations. The observed differences in measures between WF and WS patients persisted throughout and after the weaning trial. In conclusion, WF may be predicted based on higher malondialdehyde, higher vitamin C and lower nitric oxide concentration in plasma.

【 授权许可】

CC BY   
© 2015 The Authors. Journal of Cellular and Molecular Medicine published by John Wiley & Sons Ltd and Foundation for Cellular and Molecular Medicine.

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