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Related Experiment Videos

Plasma antioxidant status in septic critically ill patients: a decrease over time.

Jean-Marc Doise1, Ludwig Serge Aho, Jean-Pierre Quenot

  • 1Service de Réanimation Médicale, Facultés de Médecine et de Pharmacie, IFR No100, Dijon, France.

Fundamental & Clinical Pharmacology
|March 21, 2008
PubMed
Summary

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Total plasma antioxidant capacity (TAC) initially remains stable in sepsis but declines over time, regardless of severity. This decline is linked to uric acid, albumin, and bilirubin, not vitamins, suggesting TAC is not a reliable outcome measure for sepsis.

Area of Science:

  • Biochemistry
  • Critical Care Medicine
  • Immunology

Background:

  • Severe sepsis and septic shock induce significant intravascular oxidative stress.
  • Adaptive mechanisms in sepsis are complex and not fully understood.
  • Changes in total plasma antioxidant capacity (TAC) and specific antioxidants during sepsis require further elucidation.

Purpose of the Study:

  • To investigate the time-course changes in TAC and major plasma antioxidant concentrations in patients with severe sepsis and septic shock.
  • To compare TAC and antioxidant levels between septic patients and healthy volunteers.
  • To determine the relationship between TAC and specific antioxidants, including vitamins, uric acid, proteins, and bilirubin.

Main Methods:

  • A cohort study involving 56 septic patients (19 severe sepsis, 37 septic shock) and 6 healthy volunteers.

Related Experiment Videos

  • Daily measurement of TAC and antioxidant concentrations over a 10-day follow-up period.
  • Multivariate analysis to identify correlations between TAC and various antioxidant substances.

    • Main Results:

    • No significant difference in initial TAC levels between healthy subjects, severe sepsis, and septic shock groups.
    • An equivalent time-dependent decline in TAC was observed in both septic patient groups.
    • TAC correlated with uric acid, albumin, and bilirubin, but not with vitamins A, C, or E. Vitamin C concentrations showed a sharp, persistent decrease.
    • TAC deteriorated over time in critically ill septic patients, irrespective of severity.

    Conclusions:

    • Total plasma antioxidant capacity (TAC) is not significantly altered at the onset of sepsis but deteriorates over time.
    • TAC levels do not effectively differentiate between severe sepsis and septic shock.
    • TAC is unlikely to be a useful outcome measure for assessing sepsis severity or progression.