Abstract
Sepsis, which may be considered systemic inflammatory response syndrome facing an infectious stimulus, is the main cause of mortality in patients in ICUs. As a result of the systemic inflammatory response and of the decrease of the aerobic metabolism in sepsis, oxidative stress occurs. Vitamin A is recognized by the favorable effect that it exerts on the immune response to infections and antioxidant action. The aim of the present study was to assess the association between serum concentrations of retinol, carotenoids and oxidative stress in septic patients in the ICU. The subjects were to hospitalized adult patients with diagnosis of sepsis in the ICU from Hospital Sao Vicente de Paulo and from Hospital Universitario Clementino Fraga Filho, UFRJ, Rio de Janeiro State, Brazil, in the period from January to December 2006. The diagnosis of sepsis was based on the definitions of the International Sepsis Definitions Conference. Serum levels of retinol, total carotenoids and C-reactive protein (CRP) were measured. Oxidative stress was assessed through the lipid peroxidation dosage, which was estimated by thiobarbituric acid reactive substance (TBARS) levels. The APACHE II score was assessed. Forty-six patients were studied and divided into two groups: patients with diet (n = 24) and patients without diet (n = 22). The median age was 64.7 ± 19.4. Reduced levels of retinol and carotenoids were found in 65.2% and 73.9% of the sample, respectively. The group with diet had an inadequacy of retinol in 54% and carotenoids in 62.5%. CRP was high in 100% of the patients. The median vitamin A intake was 8,622 IU, the APACHE II score was 16.1 ± 4.68 and TBARS was 4.48 ± 4.49 nmol/ml. No significant difference was found related to retinol levels, TBARS and APACHE II score between the groups (P = 0.33/P = 0.24/P = 0.43). This was found between CRP levels and carotenoids (P = 0.001/P = 0.047). The results bring subsidies for the establishment/revision of the nutritional protocol directed to the group, particularly as regards the intake of vitamin A, aiming at improvement of the prognosis, evolution and survival of these patients.
Highlights
Clinical evidence suggests that bacterial translocation (BT) may not be the primary cause in the development of sepsis and multiple organ dysfunction
In previous work we demonstrated that platelet-derived attributed to bacterial translocation (BT), and the aggravation of microparticles (MP) can induce endothelial and vascular smooth sepsis is related to the increased vascular permeability state that muscle cell apoptosis in septic patients through NADPH oxidase- potentates the BT index
The aim of this study is to evaluate the effects of hypertonic saline (HSS) 7.5% and lactated Ringer’s (LR) solutions on intestinal BT in rats that underwent intestinal obstruction and ischaemia (IO)
Summary
Clinical evidence suggests that bacterial translocation (BT) may not be the primary cause in the development of sepsis and multiple organ dysfunction. The evolution of intensive care and its results related to the survival of very critically ill patients produce a group of survivors characterized by complex co-morbidities and prolonged dependence on mechanical ventilation (more than 21 days). Methods A prospective, nonrandomized, observational and comparative study that compares effects on PPV of the VC with another three PC ventilatory settings applied in sedated and mechanically ventilated critically ill patients with an arterial catheter in place. The APACHE II score (26.1 ± 9.5 vs 17.7 ± 6.0, P = 0.000), mean SOFA score (10.55 ± 3.41 vs 3.52 ± 2.29, P < 0.001), use of a central catheter (87.5% vs 60.7%, P = 0.001), dialysis (21.4% vs 5.4%, P = 0.013), mechanical ventilation (91.1% vs 35.7%, P < 0.001) and presence of septic shock (32.1% vs 8.9%, P = 0.002) were associated with worse prognosis. Several complications are possible, making it necessary to provide an immediate, specialized, postoperatory intensive care treatment
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
