Contribution of oxidative stress in the mechanisms of postoperative complications and multiple organ dysfunction syndrome

Abstract

Background The extent of the damage following surgery has been subject of study for several years. Numerous surgical complications can impact postoperative quality of life of patients and even can cause mortality. Although these complications are generally due to multifactorial mechanisms, oxidative stress plays a key pathophysiological role. Moreover, oxidative stress could be an unavoidable effect derived even from the surgical procedure itself. Methods A systematic review was performed following an electronic search of Pubmed and ScienceDirect databases. Keywords such as sepsis, oxidative stress, organ dysfunction, antioxidants, outcomes in postoperative complications, among others, were used. Review articles were preferably used between the years 2015 onwards, not excluding older ones. Results The vast majority point to the role of oxidative stress in generating greater damage and worse prognosis in postoperative patients without the necessary care and precautions, taking importance on the use of antioxidants to prevent this problem. Discussions Oxidative stress represents a common final pathway related to pathological processes such as inflammation or ischemia–reperfusion, among others. The expression of greater severity of these complications can result in multiple organ dysfunction or sepsis. The aim of this study was to present an update of the role of oxidative stress on surgical postoperative complications.

The mechanism of multiple organ dysfunction syndrome in patients with COVID‐19

“…12 Oxidative stress may be a contributing factor in the pathogenesis of MODS due to the association of elevated plasma levels of ROS, NO, and ONOO − with MODS. 13 By investigating the clinical characteristics of 198 patients with COVID‐19, results of a previous study demonstrated that glutathione (GSH) reductase (GR) levels were significantly increased in 40.2% patients with COVID‐19. 14 GR is known to participate in an oxidative defense system required for effective immune responses against bacterial infection.…”

Oxidant/Antioxidant Status Is Impaired in Sepsis and Is Related to Anti-Apoptotic, Inflammatory, and Innate Immunity Alterations

“…Oxidative stress: Oxidative stress represents a common final pathway related to inflammation, ischemia-reperfusion, multiple organ failure, and sepsis [ 33 ]. This is the first report showing that the acute stress-related increased expression of Hsp alarmins, cytokines, and survivin in sepsis are independently associated with TOS induction, leading to TOS/TAC imbalance, which is a strong sepsis discriminator and predictor of mortality.…”

The effect of low flow anesthesia with sevoflurane on oxidative status

“…This may prolong the healing process by causing postoperative complications and hemodynamic changes, particularly in patients with organ dysfunction or co-morbidities. 13 …”

“…This may prolong the healing process by causing postoperative complications and hemodynamic changes, particularly in patients with organ dysfunction or co-morbidities. 13 Each of the anesthetic gases and oxygen used in anesthesia can cause the formation of ROS in the organism. Oxygen is the central to all metabolic processes, but as a medication, it can cause toxicity in Kruskal-Wallis test (Post hoc: Mann-Whitney U-test), ** One-Way ANOVA test (post hoc: Bonferroni), § p-value 2 of <0.05 (compared to T1-T2, native tiol, high-flow group), † p-value 1 of <0.05 (compared to high flow group, disulfide level at time T2 in mid-flow and low flow group), § † p-value 2 of <0.05 (T2 compared to T1, disulfide/native thiol percentage), T1: pre-induction, T2: 60th minute after induction, T3: postoperative 2nd hour, SD: standard deviation a time-dependent manner.…”