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Identification and Quantification of Deranged Metabolites in Critically Ill Patients Using NMR-Based Metabolomics
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Identification and Quantification of Deranged Metabolites in Critically Ill Patients Using NMR-Based Metabolomics

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Rapid decreases of key antioxidant molecules in critically ill patients: A personalized approach

N V Margaritelis1, V Paschalis2, A A Theodorou3

  • 1Intensive Care Unit, 424 General Military Hospital of Thessaloniki, Thessaloniki, Greece; Department of Physical Education and Sports Science at Serres, Aristotle University of Thessaloniki, Serres, Greece.

Clinical Nutrition (Edinburgh, Scotland)
|May 14, 2019
PubMed
Abstract

Insights

Critically ill patients often develop severe deficiencies in key antioxidants like vitamin C, vitamin E, and glutathione. Personalized antioxidant therapy is crucial, as patient responses vary widely, impacting clinical nutrition strategies.

Area of Science:

  • Biochemistry
  • Critical Care Medicine
  • Nutritional Science

Background:

  • Oxidative stress is a significant factor in critical illness, linked to poor outcomes in Intensive Care Unit (ICU) patients.
  • Previous antioxidant treatments in ICU settings have yielded disappointing results, potentially due to indiscriminate application without considering individual patient profiles.
  • Understanding patient-specific antioxidant deficiencies is vital for effective therapeutic strategies.

Purpose of the Study:

  • To investigate differential deficiencies in vitamin C, vitamin E, glutathione, and NADPH among critically ill ICU patients.
  • To assess the relationship between antioxidant levels and systemic oxidative stress in this patient population.

Main Methods:

  • Sixty mechanically-ventilated adult medical ICU patients and 20 healthy volunteers were enrolled.
  • Antioxidant profiles (vitamin C, E, glutathione, NADPH) and systemic oxidative stress (F2-isoprostanes) were measured at ICU admission, day 1, and day 7.
  • Patient data included age, APACHE II score, and Glasgow Coma Scale.

Main Results:

  • A significant majority of ICU patients exhibited rapid and severe deficiencies (less than 50% of control values) in one, two, or all three measured antioxidants.
  • These antioxidant insufficiencies occurred despite relatively similar systemic oxidative stress levels across patients.
  • Heterogeneity in antioxidant depletion was observed among patients.

Conclusions:

  • The substantial variability in antioxidant levels among ICU patients underscores the need for patient stratification in antioxidant treatment planning.
  • Identifying patients who will respond to specific antioxidant therapies is essential for successful personalized clinical nutrition.
  • Tailoring antioxidant interventions based on individual profiles may improve treatment efficacy in critical care.
Keywords:
AntioxidantsCritical illnessDeficiencyFree radicalsOxidative stressPrecision medicine

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