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Home > Archive > Pathology > September 2005 > 50% decrease in mortality in antioxidant supplemented critically ill patients
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50% decrease in mortality in antioxidant supplemented critically ill patients
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| ironjustice@aol.com 2005-09-24, 2:00 pm |
| Anesth Analg. 2004 Sep;99(3):857-63, table of contents. Related
Articles, Links
The beneficial effects of antioxidant supplementation in enteral
feeding in critically ill patients: a prospective, randomized,
double-blind, placebo-controlled trial.
Crimi E, Liguori A, Condorelli M, Cioffi M, Astuto M, Bontempo P,
Pignalosa O, Vietri MT, Molinari AM, Sica V, Della Corte F, Napoli C.
Department of Anesthesiology and Intensive Care, university of Eastern
Piedmont, Via Solaroli 17, Novara 28100, Italy. etcrimi@tin.it
We investigated whether intervention with antioxidant vitamins C and E
in enteral feeding influenced oxidative stress and clinical outcome in
critically ill patients. Two-hundred-sixteen patients expected to
require at least 10 days of enteral feeding completed the study.
One-hundred-five patients received enteral feeding supplemented with
antioxidants, and 111 control patients received an isocaloric formula.
Plasma lipoperoxidation (by thiobarbituric acid reactive substances
[TBARS] and prostaglandin F(2alpha) isoprostane levels), low-density
lipoprotein (LDL) oxidizability, and LDL tocopherol content were
determined at baseline and at the end of the 10-day period. The
clinical 28-day outcome was also assessed. Plasma TBARS and
isoprostanes were 5.33 +/- 1.26 nM/mL and 312 +/- 68 pg/mL,
respectively, before treatment and 2.42 +/- 0.61 nM/mL and 198 +/- 42
pg/mL after intervention (P < 0.01 for both comparisons). Antioxidants
improved LDL resistance to oxidative stress by approximately 30% (the
lag time before treatment was 87 +/- 23 min and was 118 +/- 20 min
after treatment; P < 0.04). There was a significantly reduced 28-day
mortality after antioxidant intervention (45.7% in the antioxidant
group and 67.5% in the regular-feeding group; P < 0.05). Isoprostanes
may provide a sensitive biochemical marker for dose selection in
studies involving antioxidants.
Publication Types:
Clinical Trial
Randomized Controlled Trial
PMID: 15333422 [PubMed - indexed for MEDLINE]
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| ironjustice@aol.com 2005-09-24, 2:00 pm |
| Ann Clin Biochem. 2005 Jul;42(Pt 4):269-76. Related Articles, Links
Markers of oxidative damage, antioxidant status and clinical outcome in
critically ill patients.
Mishra V, Baines M, Wenstone R, Shenkin A.
Department of Clinical Biochemistry and Metabolic Medicine, Royal
Liverpool university Hospital, Liverpool L69 3GA, UK.
vinita.mishra@ribuht.nhs.uk
BACKGROUND: Oxidative stress is a consequence of critical illness, and
may have an impact on survival. We studied markers of oxidative damage
and antioxidant (AO) protection and compared them with clinical scores
and outcome.METHODS: Blood sampling and clinical scoring was carried
out on 60 consecutively admitted intensive therapy unit (ITU) patients
within 24 h of admission and then every three days of ITU stay. The
patients included 30 surgical and 30 medical patients, of whom 46
survived their stay in ITU. Clinical scoring was by Acute Physiology
and Chronic Health Evaluation (APACHE) II score, multiple organ
dysfunction (MOD) score and sepsis rating. Oxidative damage was
assessed by measurement of plasma malondialdehyde (MDA) and F2
isoprostanes (F2 IsoPs). AO protection was assessed by measurement of
plasma total AO status, AO gap, ascorbic acid and the enzymes
glutathione peroxidase and superoxide dismutase.RESULTS: Both clinical
markers, APACHE II and MOD, and oxidative damage markers MDA and F2
IsoPs were significantly higher in non-survivors (NS) than in survivors
(S) at the time of admission. Median (interquartile ranges) were
(APACHE II), 14[12--17] (S), 20.5[16.7--22.2] (NS),P<0.0001; (MOD),
3.0[2.0--5.0] (S), 8.0[4.7--9.2] (NS), P<0.0005; (MDA, mumol/L),
0.22[0.19--0.27] (S), 0.25[0.20--0.34] (NS), P=0.04 and (F2 IsoPs,
pg/mL), 9.7[6.0--9.9] (S), 11.0[9.0--12.0] (NS), P=0.01. Oxidative
damage markers reduced (improved) in the survivors but increased in the
non-survivors. There was little difference between the groups in AO
protection markers. There was a significant positive correlation
between MOD and markers of oxidative damage at the time of admission
(r=0.40, P=0.003, F2 IsoPs; r=0.28, P=0.035, MDA) and between the
oxidative damage markers themselves (r=0.32, P=0.017).CONCLUSION:
Increased oxidative stress is associated with poor outcome in
critically ill patients, and may be a prognostic indicator. Oxidative
damage markers are more useful than AO protection markers in predicting
outcome.
PMID: 15989727 [PubMed - in process]
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Who loves ya.
Tom
Jesus Was A Vegetarian!
http://jesuswasavegetarian.7h.com
Man Is A Herbivore!
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DEAD PEOPLE WALKING
http://pages.ivillage.com/ironjustice/deadpeoplewalking
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