Changes in oxidative stress from tracheal aspirates sampled during chest physical therapy in hospitalized intubated infant patients with pneumonia and secretion retention

Abstract

ObjectiveThis study aimed to show the changes in oxidative stress and clinical condition from either chest physical therapy (CPT) or CPT with aerosol treatment in infant patients with pneumonia.MethodsFrom 52 intubated patients, three groups were composed: groups A, B, and C comprising 21 patients aged 5.3±0.6 months (CPT program), 20 patients aged 5.6±0.7 months (aerosol treatment before CPT program), and eleven patients aged 5.0±0.35 months (control), respectively. CPT was composed of manual percussion and vibration before suction in a specific position for draining secretion and re-expanding collapsed lungs. Groups A and B received three sessions of treatment three times daily for 6 days, when tracheal aspirates were collected for evaluating oxidative stress markers for the thiol group: vitamin E, thiobarbituric acid reactive substances-malondialdehyde, and hyarulonan. Furthermore, lung injury score and oxygenation index (PvO2/FiO2 ratio) were recorded daily.ResultsAll parameters in group C did not change statistically during study. The thiol group increased significantly in group A after day 4, and increased significantly on days 3 and 6 when compared to day 1 in group B. Vitamin E levels increased significantly on days 3, 5, and 6 in group A, and days 3, 4, and 6 in group B, when compared to day 1. Whereas, the thiobarbituric acid reactive substances-malondialdehyde adduct showed a significant reduction after day 4 in groups A and B, when compared to day 1. Hyarulonan levels showed a significant reduction after day 3 in group A and on day 2 in group B. In addition, lung injury score decreased slightly and nonsignificantly in groups A and B, whereas the oxygenation index increased significantly after day 4 in group A and on day 6 in group B.ConclusionThese preliminary results suggest that CPT with or without aerosol treatment possibly reduces oxidative stress and enhances oxygenation status in infant patients.

Oxidant and antioxidant balance in patients with COVID‐19

“…We found that TT and NT levels were significantly lower in both pediatric and adult COVID‐19 cases with severe disease course in the present study. Our findings supported the potential utility of using thiol levels as a predictor of COVID‐19 severity, and the higher thiol levels observed in mild or moderate cases may serve as an indirect indicator of the improved antioxidant status in lung tissues due to better control of the proinflammatory processes in the lungs 24 . Additionally, our data showed that the TT and NT levels were lower in adults than in children with COVID‐19, and these levels appeared to be good predictors of COVID‐19 diagnosis, particularly among adults.…”

“…Our findings supported the potential utility of using thiol levels as a predictor of COVID‐19 severity, and the higher thiol levels observed in mild or moderate cases may serve as an indirect indicator of the improved antioxidant status in lung tissues due to better control of the proinflammatory processes in the lungs. 24 Additionally, our data showed that the TT and NT levels were lower in adults than in children with COVID‐19, and these levels appeared to be good predictors of COVID‐19 diagnosis, particularly among adults. The better thiol/DD balance observed in children might indicate they might are better protected from the harmful effects of oxidative stress than adults.…”

Oxidant and Antioxidant Balance in Children with Community-Acquired Pneumonia

“…24 Many studies have investigated thiol status in adults and children with different diseases including acute tonsillopharyngitis, meningism, meningitis, acute appendicitis, Crimean-Congo hemorrhagic fever (CCHF), and brucellosis, 21,[25][26][27][28] but few studies have examined thiol status in patients with CAP. 29,30 Consistent with our results, previous studies have found that patients had lower TT and NT levels compared with control groups. 21,25,26,28 Moreover, Aycicek et al and Oncel et al reported the same results in children as in our study.…”

“…27,28 However, our finding that outpatients had higher thiol levels supports the potential utility of thiol level as a predictor of the need for hospitalization in patients with CAP, because the higher levels in outpatients may indirectly indicate improved antioxidant status in the lung tissue due to better control of the proinflammatory processes in the lungs. 30 In one of our previous studies focused on the oxidant status of patients with CCHF, we reported that high TT may be protective against the development of CCHF infection. In other words, similar to the literature, the progression of inflammatory processes cannot be inhibited without adequate thiol levels, as in the inpatients of our study.…”

Oxidant and Antioxidant Balance in Children with Community-Acquired Pneumonia

“…Moreover, Aycicek et al and Oncel et al reported the same results in children as in our study 24,25 . However, our finding that outpatients had higher thiol levels supported the potential utility of thiol level as a predictor of CAP severity, because the higher level in outpatients may be an indirect indicator of improved antioxidant status in the lung tissue due to better control of the proinflammatory processes in the lungs 27 . In one of our previous studies focused on the oxidant status of patients with CCHF, Oncel et al reported that high TT may be protective against the development of CCHF infection.…”