Oxidative stress in critically ill patients with systemic inflammatory response syndrome.
OBJECTIVE
To evaluate whether critically ill patients with systemic inflammatory response syndrome, on admission to an intensive care unit, had more severe oxidative stress than those without this syndrome.


METHODS
A prospective, cohort study.


METHODS
A mixed medical and surgical adult intensive care unit with 12 beds.


METHODS
A total of 68 consecutive patients admitted to the intensive care unit.


METHODS
Venous blood samples were routinely obtained within 24 hrs of admission.


RESULTS
Patients' plasma total antioxidant capacity, the lipid peroxidation products malondialdehyde and 4-hydroxynonenal, reduced sulfhydryl groups, and nitrites/nitrates were measured by spectrophotometric technique at admission to the intensive care unit. Myeloperoxidase (enzyme-linked immunosorbent assay) and polymorphonuclear elastase (immuno-activation assay) were also measured on admission to the intensive care unit. The patients with criteria of systemic inflammatory response syndrome (n = 20) had higher Acute Physiology and Chronic health Evaluation III scores (determined by collecting the worst value within 24 hrs after admission to the intensive care unit) and plasma concentrations of lipid peroxidation products and nitrites/nitrates and lower plasma concentration of reduced sulfhydryl groups and plasma total antioxidant capacity than patients without the syndrome (n = 48). Moreover, the markers for leukocyte activation, myeloperoxidase and polymorphonuclear elastase, presented higher concentrations in the plasma of patients with systemic inflammatory response syndrome.


CONCLUSIONS
Patients admitted to the intensive care unit with criteria of systemic inflammatory response syndrome had a more severe oxidative stress than patients without this syndrome.
Alonso de Vega
José M
JM
Intensive Care Unit, Hospital Naval del Mediterráneo, Cartagena, Spain.
Díaz
Julián
J
Serrano
Enrique
E
Carbonell
Luis F
LF
D018806:APACHE; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D016638:Critical Illness; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007958:Leukocyte Count; D019272:Leukocyte Elastase / Q000097:blood; D015227:Lipid Peroxidation / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009566:Nitrates / Q000097:blood; D009573:Nitrites / Q000097:blood; D018384:Oxidative Stress / Q000502:physiology*; D009195:Peroxidase / Q000097:blood; D011446:Prospective Studies; D012720:Severity of Illness Index; D013030:Spain; D016019:Survival Analysis; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood / Q000401:mortality / Q000503:physiopathology*
D009566:Nitrates; D009573:Nitrites; D009195:Peroxidase; D019272:Leukocyte Elastase