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Early decrease of oxidative stress by non-invasive ventilation in patients with acute respiratory failure.

Alessia Garramone1, Roberto Cangemi2, Emanuela Bresciani1

  • 1UOC Emergency Medicine, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy.

Internal and Emergency Medicine
|September 16, 2017
PubMed
Summary

Non-invasive ventilation significantly reduces oxidative stress markers in patients with acute respiratory failure. This improvement in oxidative stress correlates with enhanced oxygenation, suggesting a beneficial role for NIV in ARF.

Keywords:
Acute respiratory failureNADPH-oxidaseNon-invasive ventilationOxidative stress

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Area of Science:

  • Pulmonology
  • Critical Care Medicine
  • Biochemistry

Background:

  • Oxidative stress is implicated in chronic respiratory diseases, with non-invasive ventilation (NIV) showing potential to mitigate oxidative damage.
  • Limited data exist on the role of oxidative stress and NIV in acute respiratory failure (ARF).
  • NADPH-oxidase activation is a key contributor to oxidative stress in respiratory conditions.

Purpose of the Study:

  • To investigate the relationship between oxidative stress and ARF.
  • To evaluate the impact of NIV on oxidative stress markers in ARF patients.
  • To assess the correlation between oxidative stress reduction and oxygenation improvement with NIV.

Main Methods:

  • Sixty ARF patients (PaO2/FiO2 ratio <300) were divided into two groups: 30 treated with NIV and 30 with conventional oxygen therapy (COT).
  • Serum levels of soluble Nox2-derived peptide (sNOX2-dp), hydrogen peroxide (H2O2), and 8-iso-PGF2α were measured at baseline and after 3 hours.
  • These markers represent NADPH-oxidase activity and oxidative stress.

Main Results:

  • Baseline levels of sNOX2-dp, H2O2, and 8-iso-PGF2α were inversely associated with the PaO2/FiO2 ratio.
  • Patients receiving NIV showed significant reductions in sNOX2-dp, H2O2, and 8-iso-PGF2α after 3 hours.
  • No significant reduction in these markers was observed in the COT group. Delta changes in oxidative stress markers correlated inversely with delta changes in PaO2/FiO2 ratio.

Conclusions:

  • Non-invasive ventilation effectively reduces oxidative stress levels within the initial hours of treatment for acute respiratory failure.
  • The observed reduction in oxidative stress is linked to improvements in the PaO2/FiO2 ratio and decreased NADPH-oxidase activity.
  • NIV demonstrates a promising therapeutic role in managing oxidative stress associated with ARF.