title: [Oxidative stress: unsolved problem in the complex therapy in critically ill patients].
abstract: BACKGROUND
  Recent reports emphasize the important role of oxidative stress in the genesis of many syndromes and diseases. The ICU patients have prerequisites for activation of oxidative stress process: activation of the neutrophils, macrophages, and other cells which are capable of producing reactive oxygen species (ROS). The traditional opinion was that lipids are the primary target of the ROS but new data show also protein damage. The interaction between ROS and lipids is an indicator for oxidative stress.
  
  
  OBJECTIVE
  Complex investigation of the parameters of oxidative stress in critically ill patients undergoing abdominal surgery.
  
  
  METHODS
  Eight patients undergoing surgery for diffuse peritonitis or acute pancreatitis were examined. The intensity of the lipid peroxidation processes was defined by the TBA-RS plasma levels. The status of the plasma antioxidant system was assessed by desoxyribose method. Patients with malignant diseases were not included.
  
  
  RESULTS
  Our results confirm the growth of oxidative stress in study patients. We observed consistent increase in MDA levels toward 3rd-5th day of postoperative period.
  
  
  CONCLUSIONS
  Oxidative stress processes have an important role in the course and outcome of surgical ICU patients. Multiple organ failure in these patients correlates well with the oxidative damage of body's protein structures. It is advisable to monitor the parameters of oxidative stress and protein damage in the course of critical illnesses.
authors.forename: S
authors.initials: S
authors.lastname: Khinev
authors.forename: D
authors.initials: D
authors.lastname: Tsoneva
authors.forename: K
authors.initials: K
authors.lastname: Dafinova
authors.forename: V
authors.initials: V
authors.lastname: Khadzhimitova
mesh_terms: D018806:APACHE; D000328:Adult; D000368:Aged; D000975:Antioxidants / Q000378:metabolism*; D016638:Critical Illness / Q000628:therapy*; D005260:Female; D006801:Humans; D008054:Lipid Peroxides / Q000097:blood; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress; D019283:Pancreatitis, Acute Necrotizing / Q000097:blood / Q000201:enzymology / Q000378:metabolism / Q000601:surgery; D010538:Peritonitis / Q000097:blood / Q000201:enzymology / Q000378:metabolism / Q000601:surgery; D017382:Reactive Oxygen Species / Q000378:metabolism
chemical_list: D000975:Antioxidants; D008054:Lipid Peroxides; D017382:Reactive Oxygen Species