Analysis of oxidative stress-related markers in critically ill polytrauma patients: An observational prospective single-center study

Bosnian Journal of Basic Medical Sciences

Carmen Alina Cradigati¹  Mirela Sarandan¹  Alexandru Florin Rogobete²  Dorel Sandesc²  Ovidiu Horea Bedreag²  Marius Papurica²  Anca Dinu³  Mihai Sandesc³  Adrian Tudor Stan³  Tiberiu Bratu³  Sonia Elena Popovici³  Lavinia Melania Bratu⁴ 

[1] Clinic of Anesthesia and Intensive Care ”Casa Austria”, Emergency County Hospital ”Pius Brinzeu”, Timisoara, Romania;Faculty of Medicine, ”Victor Babes” University of Medicine and Pharmacy, Timisoara, RomaniaClinic of Anesthesia and Intensive Care, Emergency County Hospital ”Pius Brinzeu”, Timisoara, Romania;Faculty of Medicine, ”Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania;Faculty of Pharmacy, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania;

关键词: Polytrauma patients;    trauma;    vitamin C;    N-acetylcysteine;    antioxidants;    oxidative stress;   

DOI  :  10.17305/bjbms.2018.2306

来源: DOAJ

【 摘 要 】

Critically ill polytrauma patients have increased production of free radicals (FRs) and consequent alterations in biochemical pathways, as well as disruption of cellular integrity, due to increased lipid peroxidation. The aim of this study was to investigate several biomarkers associated with increased oxidative stress in critically ill polytrauma patients, and to evaluate the effect of antioxidant treatment on the clinical outcome in these patients. A total of 67 polytrauma patients from an intensive care unit met the selection criteria. Antiox group included 35/67 patients who received antioxidant therapy, while 32/67 patients without antioxidant treatment were considered as control group. Antioxidant therapy consisted of simultaneous administration of Vitamin C (sodium ascorbate) and N-acetylcysteine, through continuous intravenous infusion. Clinical and paraclinical evaluation of the patients was performed daily until discharge or death. At admission, laboratory parameters did not differ significantly between two groups. At discharge/upon death, statistically significant differences in favor of Antiox group were observed in the following parameters: thrombocytes, activated partial thromboplastin time, prothrombin time, total bilirubin, total cholesterol, high-density lipoproteins, low-density lipoproteins, erythrocyte sedimentation rate, interleukin 6 (all p = 0.0001), total protein (p = 0.0005), serum albumin (p = 0.0004), lactate dehydrogenase (p = 0.0006), and C-reactive protein (p = 0.0014). Starting from day 5, the APACHE II score was significantly decreased in Antiox versus control group (p < 0.05). Finally, the sepsis incidence and mortality rate were significantly lower in Antiox group (p < 0.05). Decreasing the level of oxidative stress by antioxidant substances significantly correlated with a better prognosis and outcome in our patients. Further studies should elucidate more clearly the mechanism of action of antioxidants in critically ill polytrauma patients.

【 授权许可】

Unknown