The impact of acute lung injury, ECMO and transfusion on oxidative stress and plasma selenium levels in an ovine model.
The purpose of this study was to determine the effects of smoke induced acute lung injury (S-ALI), extracorporeal membrane oxygenation (ECMO) and transfusion on oxidative stress and plasma selenium levels. Forty ewes were divided into (i) healthy control (n=4), (ii) S-ALI control (n=7), (iii) ECMO control (n=7), (iv) S-ALI+ECMO (n=8) and (v) S-ALI+ECMO+packed red blood cell (PRBC) transfusion (n=14). Plasma thiobarbituric acid reactive substances (TBARS), selenium and glutathione peroxidase (GPx) activity were analysed at baseline, after smoke injury (or sham) and 0.25, 1, 2, 6, 7, 12 and 24h after initiation of ECMO. Peak TBARS levels were similar across all groups. Plasma selenium decreased by 54% in S-ALI sheep (1.36±0.20 to 0.63±0.27μmol/L, p<0.0001), and 72% in sheep with S-ALI+ECMO at 24h (1.36±0.20 to 0.38±0.19, p<0.0001). PRBC transfusion had no effect on TBARS, selenium levels or glutathione peroxidase activity in plasma. While ECMO independently increased TBARS in healthy sheep to levels which were similar to the S-ALI control, the addition of ECMO after S-ALI caused a negligible increase in TBARS. This suggests that the initial lung injury was the predominant feature in the TBARS response. In contrast, the addition of ECMO in S-ALI sheep exacerbated reductions in plasma selenium beyond that of S-ALI or ECMO alone. Clinical studies are needed to confirm the extent and duration of selenium loss associated with ECMO.
Critical Care Research Group, The Prince Charles Hospital and The University of Queensland, Chermside, Queensland, Australia; Department of Anaesthesia and Perfusion, The Prince Charles Hospital, Chermside, Queensland, Australia. Electronic address: charles.mcdonald@health.qld.gov.au.
Charles I
CI
McDonald
Critical Care Research Group, The Prince Charles Hospital and The University of Queensland, Chermside, Queensland, Australia; Inflammation and Healing Research Cluster, School of Health and Sport Sciences, University of the Sunshine Coast, Queensland, Australia. Electronic address: ylfung@usc.edu.au.
Yoke Lin
YL
Fung
Critical Care Research Group, The Prince Charles Hospital and The University of Queensland, Chermside, Queensland, Australia; Adult Intensive Care Service, The Prince Charles Hospital, Chermside, Queensland, Australia. Electronic address: kiran.shekar@health.qld.gov.au.
Kiran
K
Shekar
Critical Care Research Group, The Prince Charles Hospital and The University of Queensland, Chermside, Queensland, Australia. Electronic address: sara_diab5@hotmail.com.
Sara D
SD
Diab
Critical Care Research Group, The Prince Charles Hospital and The University of Queensland, Chermside, Queensland, Australia; Biomedical Engineering and Medical Physics, Science and Engineering Faculty, Queensland University of Technology, Gardens Point, Brisbane, Queensland, Australia. Electronic address: k.dunster@qut.edu.au.
Kimble R
KR
Dunster
Critical Care Research Group, The Prince Charles Hospital and The University of Queensland, Chermside, Queensland, Australia. Electronic address: m.passmore@uq.edu.au.
Margaret R
MR
Passmore
Critical Care Research Group, The Prince Charles Hospital and The University of Queensland, Chermside, Queensland, Australia. Electronic address: samuelrfoley@gmail.com.
Samuel R
SR
Foley
Critical Care Research Group, The Prince Charles Hospital and The University of Queensland, Chermside, Queensland, Australia; Research and Development Division, Australian Red Cross Blood Service, Brisbane, Queensland, Australia. Electronic address: g.simonova@uq.edu.au.
Gabriela
G
Simonova
Critical Care Research Group, The Prince Charles Hospital and The University of Queensland, Chermside, Queensland, Australia; Department of Echocardiography, The Prince Charles Hospital, Chermside, Queensland, Australia. Electronic address: david.platts@health.qld.gov.au.
David
D
Platts
Critical Care Research Group, The Prince Charles Hospital and The University of Queensland, Chermside, Queensland, Australia; Adult Intensive Care Service, The Prince Charles Hospital, Chermside, Queensland, Australia. Electronic address: john.fraser@health.qld.gov.au.
John F
JF
Fraser
D055371:Acute Lung Injury / Q000097:blood* / Q000209:etiology*; D000818:Animals; D001803:Blood Transfusion; D004195:Disease Models, Animal; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D005979:Glutathione Peroxidase / Q000097:blood; D018384:Oxidative Stress; D012643:Selenium / Q000097:blood*; D012756:Sheep; D012907:Smoking / Q000009:adverse effects; D017392:Thiobarbituric Acid Reactive Substances / Q000378:metabolism
D017392:Thiobarbituric Acid Reactive Substances; D005979:Glutathione Peroxidase; D012643:Selenium
Acute lung injury; Antioxidants; Extracorporeal membrane oxygenation; Oxidative stress; Selenium