Antioxidant status in patients with acute respiratory distress syndrome.
OBJECTIVE
Reactive oxygen species (ROS) have been implicated in the pathophysiology of ARDS. We investigated the pattern of antioxidants in plasma and ROS production by neutrophils in patients with ARDS over 6 days.


METHODS
Observational study. Blood samples were taken when the diagnosis was made (D0) and after 3 (D3) and 6 days (D6) during therapy.


METHODS
Intensive care units at a University Hospital.


METHODS
Eight patients with ARDS were investigated, 17 healthy volunteers served as controls.


RESULTS
Plasma levels of ascorbate, alpha-tocopherol, retinol, beta-carotene, selenium and lipid peroxidation products (MDA) were determined and the activities of the antioxidative enzymes catalase (CAT), superoxide dismutase (SOD) and glutathione-peroxidase (GSH-PX) in erythrocytes were measured. In addition, ROS production (superoxide anion and hydrogen peroxide) in activated neutrophils was assessed. Plasma levels of alpha-tocopherol, ascorbate, beta-carotene and selenium were reduced from the onset of illness. MDA plasma levels were increased throughout the illness. ROS generation from neutrophils was normal on D0 and decreased to D6 in ARDS patients.


CONCLUSIONS
The antioxidative system is severely compromised in patients with ARDS. Plasma levels of alpha-tocopherol, ascorbate, beta-carotene and selenium are decreased. Elevated MDA levels provide further evidence of massive oxidative stress. The routine replacement of micronutrients according to recommended daily allowances was inadequate to compensate for the increased requirements.
Metnitz
P G
PG
Dept. of Anesthesia and General Intensive Care, Vienna General Hospital, University of Vienna, Austria.
Bartens
C
C
Fischer
M
M
Fridrich
P
P
Steltzer
H
H
Druml
W
W
D000328:Adult; D000975:Antioxidants / Q000378:metabolism*; D002648:Child; D002851:Chromatography, High Pressure Liquid; D005260:Female; D005979:Glutathione Peroxidase / Q000097:blood; D006801:Humans; D007362:Intensive Care Units; D015227:Lipid Peroxidation; D008297:Male; D018977:Micronutrients; D008875:Middle Aged; D009504:Neutrophils / Q000378:metabolism; D018673:Nutrition Policy; D010288:Parenteral Nutrition; D017382:Reactive Oxygen Species / Q000378:metabolism*; D012128:Respiratory Distress Syndrome / Q000097:blood / Q000145:classification / Q000201:enzymology / Q000378:metabolism*; D012720:Severity of Illness Index; D013482:Superoxide Dismutase / Q000097:blood; D014815:Vitamins / Q000097:blood
D000975:Antioxidants; D018977:Micronutrients; D017382:Reactive Oxygen Species; D014815:Vitamins; D005979:Glutathione Peroxidase; D013482:Superoxide Dismutase