scholarly journals Redox Changes Induced by General Anesthesia in Critically Ill Patients with Multiple Traumas

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Marius Papurica ◽  
Alexandru Florin Rogobete ◽  
Dorel Sandesc ◽  
Raluca Dumache ◽  
Radu Nartita ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
General Anesthesia ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Trauma Team ◽  
Multiple Organ ◽  
Cellular Mechanisms ◽  
Surgical Interventions ◽  
Polytrauma Patient ◽  
Multiple Traumas

The critically ill polytrauma patient is a constant challenge for the trauma team due to the complexity of the complications presented. Intense inflammatory response and infections, as well as multiple organ dysfunctions, significantly increase the rate of morbidity and mortality in these patients. Moreover, due to the physiological and biochemical imbalances present in this type of patients, the bioproduction of free radicals is significantly accelerated, thus installing the oxidative stress. In the therapeutic management of such patients, multiple surgical interventions are required and therefore they are being subjected to repeated general anesthesia. In this paper, we want to present the pathophysiological implications of oxidative stress in critically ill patients with multiple traumas and the implications of general anesthesia on the redox mechanisms of the cell. We also want to summarize the antioxidant treatments able to reduce the intensity of oxidative stress by modulating the biochemical activity of some cellular mechanisms.

scholarly journals The influence of metabolic imbalances and oxidative stress on the outcome of critically ill polytrauma patients: a review

2017 ◽  
Vol 5 ◽  
Author(s):  
Alexandru Florin Rogobete ◽  
Dorel Sandesc ◽  
Marius Papurica ◽  
Emil Robert Stoicescu ◽  
Sonia Elena Popovici ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Intensive Care ◽  
Critically Ill ◽  
Multiple Organ ◽  
Care Physician ◽  
Energy Status ◽  
Monitoring Methods ◽  
Mathematical Equations ◽  
Inadequate Nutrition ◽  
Polytrauma Patient

Abstract The critically ill polytrauma patient presents with a series of associated pathophysiologies secondary to the traumatic injuries. The most important include systemic inflammatory response syndrome (SIRS), sepsis, oxidative stress (OS), metabolic disorders, and finally multiple organ dysfunction syndrome (MODS) and death. The poor outcome of these patients is related to the association of the aforementioned pathologies. The nutrition of the critically ill polytrauma patient is a distinct challenge because of the rapid changes in terms of energetic needs associated with hypermetabolism, sepsis, SIRS, and OS. Moreover, it has been proven that inadequate nutrition can prolong the time spent on a mechanical ventilator and the length of stay in an intensive care unit (ICU). A series of mathematical equations can predict the energy expenditure (EE), but they have disadvantages, such as the fact that they cannot predict the EE accurately in the case of patients with hypermetabolism. Indirect calorimetry (IC) is another method used for evaluating and monitoring the energy status of critically ill patients. In this update paper, we present a series of pathophysiological aspects associated with the metabolic disaster affecting the critically ill polytrauma patient. Furthermore, we present different non-invasive monitoring methods that could help the intensive care physician in the adequate management of this type of patient.

scholarly journals Real‐Time Energy Exposure Is Associated With Increased Oxidative Stress Among Feeding‐Tolerant Critically Ill Patients: Results From the FEDOX Trial

2020 ◽  
Vol 44 (8) ◽  
pp. 1484-1491 ◽  
Author(s):  
Liam McKeever ◽  
Sarah J. Peterson ◽  
Sofia Cienfuegos ◽  
Jaime Rizzie ◽  
Omar Lateef ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Real Time ◽  
Critically Ill ◽  
Critically Ill Patients

Oxidative Stress in Critically Ill Patients

2002 ◽  
Vol 11 (6) ◽  
pp. 543-551 ◽  
Author(s):  
Caryl Goodyear-Bruch ◽  
Janet D. Pierce
Keyword(s):  
Oxidative Stress ◽  
Reactive Oxygen Species ◽  
Superoxide Dismutase ◽  
Free Radicals ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Oxygen Free Radicals ◽  
Oxygen Species ◽  
Defense System ◽  
Oxygen Derived Free Radicals

Oxygen-derived free radicals play an important role in the development of disease in critically ill patients. Normally, oxygen free radicals are neutralized by antioxidants such as vitamin E or enzymes such as superoxide dismutase. However, in patients who require intensive care, oxygen free radicals become a problem when either a decrease in the removal or an overproduction of the radicals occurs. This oxidative stress and the damage due to it have been implicated in many diseases in critically ill patients. Many drugs and treatments now being investigated are directed toward preventing the damage from oxidative stress. The formation of reactive oxygen species, the damage caused by them, and the body’s defense system against them are reviewed. New interventions are described that may be used in critically ill patients to prevent or treat oxidative damage.

Metabolic encephalopathy in critically ill patients suffering from septic or nonseptic multiple organ failure

2000 ◽  
Vol 28 (5) ◽  
pp. 1310-1315 ◽  
Author(s):  
Christian Zauner ◽  
Alexandra Gendo ◽  
Ludwig Kramer ◽  
Alexander Kranz ◽  
Georg Grimm ◽  
...  
Keyword(s):  
Multiple Organ Failure ◽  
Organ Failure ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Multiple Organ ◽  
Metabolic Encephalopathy

scholarly journals From Multiple Organ Support Therapy to Extracorporeal Organ Support in Critically Ill Patients

2019 ◽  
Vol 48 (2) ◽  
pp. 99-105 ◽  
Author(s):  
Claudio Ronco ◽  
Zaccaria Ricci ◽  
Faeq Husain-Syed
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Journal Club ◽  
Multiple Organ ◽  
Artificial Organs ◽  
Organ Support ◽  
Future Research ◽  
Advantages And Disadvantages ◽  
Early Implementation ◽  
Open Debate

Critically ill patients developing severe forms multiple organ dysfunction syndrome (MODS) may not be adequately supported by pharmacologic management. In these complex cases, a single form of extracorporeal organ support (ECOS) may be required, but multiple organ support therapy (MOST) is currently seen as a feasible approach. Severe renal dysfunction is a typical syndrome requiring renal replacement therapy (RRT) in the context of MODS. After more than a decade of RRT application in various intensive care settings, ECOS are not anymore seen as extraordinary or particularly aggressive techniques in MODS patients. Nowadays, a significant increase in the use of extracorporeal membrane oxygenation and extracorporeal carbon dioxide removal is occurring. When renal and cardio-pulmonary ECOS are used together, a multidisciplinary approach is necessary to minimize negative interactions and unwanted adverse effects. In this editorial, we focus on the organ crosstalk between the native and artificial organs, including the advantages and disadvantages of organ support on multiorgan function. Much of current experience on MOST has been gained upon RRT connected to other organ support therapies. Overall, available literature has not definitely established the ideal timing of these interventions, and whether early implementation impacts organ recovery and optimizes resource utilization is still a matter of open debate: it is possible that future research will be devoted to identify patient groups that may benefit from short- and long-term multiple organ support. Video Journal Club “Cappuccino with Claudio Ronco” at  https://www.karger.com/Journal/ArticleNews/490694?sponsor=52

SOLUBLE FAS LEVELS CORRELATE WITH MULTIPLE ORGAN DYSFUNCTION SEVERITY, SURVIVAL AND NITRATE LEVELS, BUT NOT WITH CELLULAR APOPTOTIC MARKERS IN CRITICALLY ILL PATIENTS

Shock ◽  
2000 ◽  
Vol 14 (2) ◽  
pp. 107-112 ◽  
Author(s):  
Elizabeth D. E. Papathanassoglou ◽  
Jan A. Moynihan ◽  
Dianne L. Vermillion ◽  
Michael P. McDermott ◽  
Michael H. Ackerman
Keyword(s):  
Critically Ill ◽  
Organ Dysfunction ◽  
Critically Ill Patients ◽  
Multiple Organ ◽  
Multiple Organ Dysfunction ◽  
Soluble Fas ◽  
Apoptotic Markers

scholarly journals REducing Deaths due to OXidative Stress (The REDOXS© Study): rationale and study design for a randomized trial of glutamine and antioxidant supplementation in critically-ill patients

2006 ◽  
Vol 65 (3) ◽  
pp. 250-263 ◽  
Author(s):  
Daren K. Heyland ◽  
Rupinder Dhaliwal ◽  
Andrew G. Day ◽  
John Muscedere ◽  
John Drover ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Randomized Trial ◽  
Critically Ill ◽  
Organ Dysfunction ◽  
Critically Ill Patients ◽  
Tertiary Care ◽  
Antioxidant Therapy ◽  
Favourable Effect ◽  
High Dose ◽  
Antioxidant Supplementation

Critically-ill patients experience an extent of hyperinflammation, cellular immune dysfunction, oxidative stress and mitochondrial dysfunction. Supplementation with key nutrients, such as glutamine and antioxidants, is most likely to have a favourable effect on these physiological derangements, leading to an improvement in clinical outcomes. The results of two meta-analyses suggest that glutamine and antioxidants may be associated with improved survival. The purpose of the present paper is to report the background rationale and study protocol for the evaluation of the effect of high-dose glutamine and antioxidant supplementation on mortality in a large-scale randomized trial in 1200 mechanically-ventilated, critically-ill patients. Patients admitted to an intensive care unit (ICU) with clinical evidence of severe organ dysfunction will be randomized to one of four treatments in a 2×2 factorial design: (1) glutamine; (2) antioxidant therapy; (3) glutamine and antioxidant therapy; (4) placebo. The primary outcome for this study is 28 d mortality. The secondary outcomes are duration of stay in ICU, adjudicated diagnosis of infection, multiple organ dysfunction, duration of mechanical ventilation, length of stay in hospital and health-related quality of life at 3 and 6 months. A novel design feature is the combined use of parenteral and enteral study nutrients dissociated from the nutrition support. The therapeutic strategies tested in the randomized trial may lead to less morbidity and improved survival in critically-ill patients. The trial will be conducted in approximately twenty tertiary-care ICU in Canada and the first results are expected in 2009.

Sign in / Sign up

Export Citation Format

Share Document