Oxidative stress status: possible guideline for clinical management of critically ill patients.
BACKGROUND
Critical care medicine has developed in the last few years into a separate scientific discipline and studies related to the outcome after intensive care usually suggest a long hospital stay that becomes cost prohibitive. The majority of problems (death) amongst critically ill patients requiring critical care involve sepsis, inflammation, tissue damage-oxidative stress, oxygen tension PO2, lipid peroxidation. The present investigation involves monitoring of serum levels of MDA, SOD as a possible guideline for severity of clinical situations in critically ill patients.


METHODS
Fifty critically ill heterogeneous patients requiring intensive care in the ICU of IKDRC were selected as subjects with ages varying from 17 to 75 years. Serum levels of MDA (ng/ml), SOD (U/ml) were determined right from admission to discharge due to improvement / DAMA / death. MDA and SOD were estimated according to the methods of Buege and Aust et al. (1978), Nandi and Chatterji (1988).


RESULTS
Critically ill patients irrespective of the disease process indicated significantly very high serum levels of MDA and low levels of SOD at the time of admission (13.28+/-4.26 ng/ml, 3.80+/-2.60 U/ml, respectively) according to the severity of the prevalent clinical situation. The pattern of serum levels of MDA and SOD according to subsequent clinical performance did indicate a decreasing trend of MDA (oxidant) and fluctuating trend of SOD (antioxidant enzyme except in those who inevitably succumbed to death in spite of adequate clinical management.


CONCLUSIONS
The results of the present study have amply revealed the utility and relevance of monitoring oxidative stress in critically ill patients as biochemical markers, cost-effectiveness and role in decision making (withdrawal/continuation of different support modalities) as deemed fit.
Bela
P
P
Departments of Biochemistry, Anaesthesiology, Institute of Kidney Disease and Research Centre Ahmedabad, India.
Bahl
R
R
Sane
A S
AS
Sawant
P H
PH
Shah
V R
VR
Mishra
V V
VV
Trivedi
H L
HL
D000293:Adolescent; D000328:Adult; D000368:Aged; D016638:Critical Illness / Q000628:therapy*; D006801:Humans; D008315:Malondialdehyde / Q000097:blood; D008875:Middle Aged; D018384:Oxidative Stress; D017410:Practice Guidelines as Topic; D012720:Severity of Illness Index; D013482:Superoxide Dismutase / Q000097:blood
D008315:Malondialdehyde; D013482:Superoxide Dismutase