thiobarbituric-acid and Shock--Septic

To estimate the capacity of plasma from septic shock patients to induce in vitro reactive oxygen species (ROS) production by endothelial cells and to analyze whether ROS production is related to the severity of the septic shock.. Prospective, observational study.. Medical intensive care unit in a university hospital.. Twenty-one patients with septic shock.. The in vitro capacity of plasma from septic shock patients to induce ROS production by naive human umbilical vein endothelial cells (HUVEC) was quantified by using a fluorescent probe (2',7'-dichlorodihydrofluorescein diacetate).. Blood samples were collected on day 1, day 3, and day 5 from 21 consecutive septic shock adult patients and from ten healthy volunteers. Patients mean age was 58 yrs old, mean Sequential Organ Failure Assessment (SOFA) score at admission was 12, mean severity illness assessed by Simplified Acute Physiology Score (SAPS) II was 53, and the mortality rate was 47%. In addition to assessment of in vitro ROS generation by HUVEC, oxidative stress in blood was evaluated by measuring lipid peroxidation products and enzymatic and nonenzymatic antioxidants. Septic shock was associated with oxidative stress and an imbalance in antioxidant status. As compared with controls, plasma-induced ROS production by naive HUVEC was significantly higher in septic shock. Moreover ROS production was significantly correlated with SAPS II (p = .028) and SOFA values (p = .0012) and was higher in nonsurvivors than in survivors. In contrast, no correlation was found between the severity of the septic shock and any of the levels of lipid peroxidation products or enzymatic and nonenzymatic antioxidants.. Plasma from septic shock patients induces ROS formation by naive HUVEC, and the extent of ROS formation correlates with mortality and with criteria of the severity of septic shock as SOFA score and SAPS II.

Topics: Adult; Aged; Aged, 80 and over; Antioxidants; Endothelial Cells; Female; France; Hospital Mortality; Humans; In Vitro Techniques; Lipid Peroxidation; Male; Malondialdehyde; Middle Aged; Oxidative Stress; Plasma; Reactive Oxygen Species; Severity of Illness Index; Shock, Septic; Statistics as Topic; Survival Rate; Thiobarbiturates

To determine serum bleomycin-detectable ¿free' iron in patients with septic shock and to relate these findings to both outcome and a marker of free radical damage.. A prospective observational study.. A nine-bed intensive care unit in a university teaching hospital.. Sixteen consecutive patients with septic shock, defined as: (1) Clinical evidence of acute infection; (2) hypo- or hyperthermia ( < 35.6 degrees or > 38.3 degrees C); (3) tachypnoea ( > 20 breaths/min or ventilated); (4) tachycardia ( > 90 beats min); (5) shock (systolic pressure < 90mmHg) or on inotropes. Fourteen patients also had secondary organ dysfunction.. Bleomycin-detectable iron concentrations were elevated in all patients (37.2 +/- 11.0 mumols/l vs 5.1 +/- 3.3 mumols/l in healthy subjects, P < 0.0001), but there was no difference between patients who died and those who survived (39.2 +/- 9.3 and 36.2 +/- 12.3 mumols/l, respectively). Thiobarbituric acid reactive substances (an index of lipid peroxidation) were higher in those who died (3.33 +/- 2.29 mumols/l) than in the surviving patients (0.99 +/- 0.14 mumols/l, P < 0.01) or healthy subjects (0.92 +/- 0.39 mumols/l, P < 0.01). Free iron did not correlate with thiobarbituric acid-reactive substances. However, a significant correlation was found between lipid peroxidation and clinical severity (APACHE II) score (r = 0.54, P < 0.05).. The present study provides evidence of lipid peroxidation in patients who die with septic shock. The data suggest that iron-catalysed hydroxyl radical generation does not form an important contribution to this lipid peroxidation in patients with sepsis.

Topics: Adolescent; Adult; Aged; APACHE; Biomarkers; Bleomycin; Case-Control Studies; Free Radicals; Humans; Lipid Peroxidation; Middle Aged; Prospective Studies; Shock, Septic; Survival Analysis; Thiobarbiturates

Topics: Animals; Blood Pressure; Catalase; Complement System Proteins; Endotoxins; Escherichia coli; Free Radicals; Heart Rate; Models, Biological; Neutrophils; Oxygen; Rats; Shock, Septic; Superoxide Dismutase; Thiobarbiturates