Reduction of non-enzymatic antioxidants in plasma during ECMO-treatment in ARDS by influence A H1N1

In critically ill patient it is observed a severe oxidative stress, not only due to the acute pathology but also for some therapeutic treatments. The aim of the present study was to analyze the variations of non-enzymatic antioxidants in plasma during veno-venous ECMO-treatment in a homogeneous population of critical patients with ARDS.

We carried out a retrospective study enrolling all patients with ARDS by influence A H1N1 treated with veno-venous ECMO. In all patients included, we have recorded clinical and laboratory parameters considered indicators of oxidative stress during the first week of treatment.

With regard to non-enzymatic antioxidants evaluated, we observed that both albumin and uric acid decreased significantly, at all observation times, after ECMO-treatment [(25.88±4.51, 18.05±4.27, 16.32±4.57, 19.07±5.10, p<0.05)(g/l), (5.46±1.43, 2.30±1.15, 2.90±2.09, 2.07±1.03, p<0.05)(mg/dl), respectively]. At the same time the amount of insulin administered daily was increased with statistical significance (p=0.03).

The veno-venous ECMO-treatment causes a significant reduction of some of the major non-enzymatic antioxidants and a possible increase in insulin resistance in patients with ARDS by influence A H1N1.