title: Total antioxidant capacity and total oxidant status after surfactant treatment in preterm infants with respiratory distress syndrome.
abstract: BACKGROUND
  Oxidative damage is important in the pathogenesis of respiratory distress syndrome (RDS). However, data on the effect of surfactant therapy on oxidative stress in vivo are limited. We aimed to evaluate the oxidant/antioxidant status in preterm infants with RDS via measurement of total antioxidant capacity (TAC) and total oxidant status (TOS), to determine the effect of surfactant on oxidant/antioxidant balance and to assess the association between TAC, TOS and clinical outcomes of the patients.
  
  
  METHODS
  Sixty-nine infants with RDS were included. Blood samples for determining TAC and TOS were collected before and 48 h after surfactant treatment. TAC and TOS levels were analysed in serum. Patients were followed up until discharge or death.
  
  
  RESULTS
  Post-surfactant TAC levels were significantly higher than pre-surfactant TAC levels (P = 0.029). TAC/TOS ratio significantly increased after surfactant treatment (P = 0.018). Infants <28 weeks of gestational age had lower levels of baseline TAC than those ≥28 weeks of gestational age (P = 0.020), whereas TOS levels were similar. Baseline TAC/TOS ratio was lower in infants who died in the study period than those who survived (P = 0.023). After controlling gestational age, baseline TAC levels were significantly and inversely correlated with the duration of total respiratory support (r = -0.343; P = 0.009) and hospitalization (r = -0.341; P = 0.009). TAC or TOS levels were not associated with the development of bronchopulmonary dysplasia or other complications as determined during the investigation period.
  
  
  CONCLUSIONS
  Oxidant-antioxidant balance shifts in favour of the antioxidant system after surfactant treatment. Lower TAC/TOS ratio in preterm infants may be associated with increased mortality.
authors.affiliation: Zekai Tahir Burak Maternity and Teaching Hospital, Neonatal Intensive Care Unit, 06111 Ankara, Turkey. drevrim@yahoo.com
authors.forename: Evrim Alyamac
authors.initials: EA
authors.lastname: Dizdar
authors.forename: Nurdan
authors.initials: N
authors.lastname: Uras
authors.forename: Suna
authors.initials: S
authors.lastname: Oguz
authors.forename: Omer
authors.initials: O
authors.lastname: Erdeve
authors.forename: Fatma Nur
authors.initials: FN
authors.lastname: Sari
authors.forename: Cumhur
authors.initials: C
authors.lastname: Aydemir
authors.forename: Ugur
authors.initials: U
authors.lastname: Dilmen
mesh_terms: D000328:Adult; D000975:Antioxidants / Q000378:metabolism*; D001205:Ascorbic Acid / Q000097:blood; D052160:Benzothiazoles / Q000737:chemistry; D001663:Bilirubin / Q000097:blood; D001688:Biological Products / Q000627:therapeutic use*; D005260:Female; D005978:Glutathione / Q000097:blood; D006801:Humans; D006861:Hydrogen Peroxide / Q000097:blood*; D007231:Infant, Newborn; D007234:Infant, Premature / Q000097:blood*; D008054:Lipid Peroxides / Q000097:blood*; D008297:Male; D018384:Oxidative Stress; D010743:Phospholipids / Q000627:therapeutic use*; D011247:Pregnancy; D011663:Pulmonary Surfactants / Q000627:therapeutic use*; D012127:Respiratory Distress Syndrome, Newborn / Q000097:blood / Q000188:drug therapy*; D013451:Sulfonic Acids / Q000737:chemistry; D016896:Treatment Outcome; D014527:Uric Acid / Q000097:blood; D014810:Vitamin E / Q000097:blood; D055815:Young Adult
chemical_list: D000975:Antioxidants; D052160:Benzothiazoles; D001688:Biological Products; D008054:Lipid Peroxides; D010743:Phospholipids; D011663:Pulmonary Surfactants; D013451:Sulfonic Acids; D014810:Vitamin E; D014527:Uric Acid; C002502:2,2'-azino-di-(3-ethylbenzothiazoline)-6-sulfonic acid; D006861:Hydrogen Peroxide; D005978:Glutathione; C068291:poractant alfa; D001205:Ascorbic Acid; D001663:Bilirubin