Role of edaravone in managemant of septic peritonitis

Sepsis is a complex rapidly progressive infectious disease that remain a major cause of morbidity and mortality in surgical patients and trauma victims. Edaravone a novel free radical scavenger was approved in 2001 in Japan for treatment of acute cerebral and myocardial infarction. Hence, in this work we attempt to evaluate its role in cases of septic peritonitis (SP).

This is a prospective randomized observer-blinded study carried out in surgical Intensive Care Unit (ICU) after approval by Hospital Ethical Committee. After admission to ICU patients were randomly divided into two groups of thirty patients each-Group (C): Control group managed according to the routine protocol of sepsis and Group (E): Edaravone treated SP managed according to the routine protocol of sepsis + edaravone at dose of 30 mg/12 h intravenous infusion for 2 weeks. All patients were monitored for invasive blood pressure, central venous pressure, heart rate, temperature, urine output, total fluid balance, and routine investigation. Blood sample was taken weekly for 2 weeks to measure the following parameters: Nuclear transcription factor kappa B activity (NFKB), mitogen-activated protein kinase (MAPK), heat shock protein 72 (HSP 72) and total antioxidant capacity (TAC).

There was significant decrease (P < 0.05) in serum level of NFKB, MAPK in Group E in comparison with Group C. While serum level of HSP 72 and TAC showed significant increase (P < 0.05) in Group E compared with Group C with better outcome.

SP treatment with edaravone could significantly improve the inflammatory and oxidative states with better patient outcomes.