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Plasma redox status relates to severity in critically ill patients
J M Alonso de Vega1, J Díaz, E Serrano
1Intensive Care Unit, Hospital Naval del Mediterráneo, Cartagena, Spain.
Objective:
To determine the relation between plasma redox status and severity of illness for patients admitted to an intensive care unit (ICU).
Design:
A prospective cohort study.
Setting:
A mixed medical and surgical adult ICU with 12 beds.
Patients:
A total of 73 consecutive patients admitted to the ICU.
Interventions:
Venous blood samples were routinely obtained within 24 hrs of admission.
Measurements And Main Results:
Plasma total antioxidant capacity and lipoperoxides were measured by spectrophotometric technique at admission to the ICU. The plasma ratio total antioxidant capacity (mM)/lipoperoxides (microM) was used as an index of plasma redox status. Plasma concentration of the markers of leukocyte activation myeloperoxidase (enzyme-linked immunosorbent assay) and polymorphonuclear-elastase (immunoactivation assay) were also measured at admission to the ICU. Analysis of correlation between plasma ratio total antioxidant capacity/lipoperoxides and APACHE III score showed a negative association (p < .001, Spearman correlation test). Myeloperoxidase and polymorphonuclear-elastase correlated positively with Acute Physiology and Chronic Health Evaluation III scores (r2 = 0.58; p < .001; and r2 = 0.05; p = .035; respectively).
Conclusions:
Plasma redox status relates to severity in critically ill patients. We propose that it would be reasonable to provide antioxidant therapy as part of routine management of patients admitted to a mixed ICU, regardless of the specific reason for ICU admission. Plasma redox status might become useful to evaluate the risk in critically ill patients.