title: Plasma lipid peroxides and antioxidants in human septic shock.
abstract: In order to assess if an oxidant/antioxidant imbalance is involved in human septic shock and its outcome, we measured plasma levels of the lipid peroxides malondialdehyde--as thiobarbituric acid reactive substance--conjugated dienes and fluorescent products, together with the antioxidants alpha-tocopherol, glutathione peroxidase activity and selenium in 12 patients with septic shock and compared them with values of normal controls. At first measurements, malondialdehyde (median 3.9 mumol/l; range 2-38.8) and fluorescent products (median 21.2%; range 9.4-134) were elevated (p less than 0.05), alpha-tocopherol (median 15 mumol/l; range 7-25) and selenium (median 0.76 micrograms/ml; range 0.49-1.09) were depressed (p less than 0.05). Conjugated dienes and glutathione peroxidase activity were in the normal range. In non-survivors (n = 5) initial levels of malondialdehyde and fluorescent products (median 11 versus 3.1 mumol/l; 74 versus 13% respectively) were higher than in survivors (p less than 0.05) and initial selenium levels were lower (median 0.58 versus 0.92 micrograms/l; p less than 0.05). These results are consistent with the concept that an oxidant/antioxidant imbalance--as indicated by elevated plasma lipid peroxides and depressed antioxidants--is involved in human septic shock and a fatal outcome.
authors.affiliation: Medical Intensive Care Unit, Free University Hospital, The Netherlands.
authors.forename: A C
authors.initials: AC
authors.lastname: Ogilvie
authors.forename: A B
authors.initials: AB
authors.lastname: Groeneveld
authors.forename: J P
authors.initials: JP
authors.lastname: Straub
authors.forename: L G
authors.initials: LG
authors.lastname: Thijs
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000975:Antioxidants / Q000737:chemistry*; D004966:Estrogens, Conjugated (USP) / Q000097:blood; D005069:Evaluation Studies as Topic; D005260:Female; D005979:Glutathione Peroxidase / Q000097:blood; D006801:Humans; D007773:Lactates / Q000097:blood; D019344:Lactic Acid; D008054:Lipid Peroxides / Q000097:blood*; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012643:Selenium / Q000097:blood; D012720:Severity of Illness Index; D012772:Shock, Septic / Q000097:blood* / Q000378:metabolism / Q000401:mortality; D015996:Survival Rate; D014810:Vitamin E / Q000097:blood
chemical_list: D000975:Antioxidants; D004966:Estrogens, Conjugated (USP); D007773:Lactates; D008054:Lipid Peroxides; D014810:Vitamin E; D019344:Lactic Acid; D008315:Malondialdehyde; D005979:Glutathione Peroxidase; D012643:Selenium