Free Radical and Antioxidant Levels in Patients with Secondary Peritonitis and Their Prognostic Significance

Abstract

Background: The clinical outcome of patients with secondary bacterial peritonitis depends on the production of superoxides involved in bacterial killing and the endogenous level of antioxidants. The prognostic significance of their levels has not previously been investigated. Patients and Methods: Forty-five patients undergoing surgery for secondary peritonitis were prospectively evaluated. Severity of illness at admission (APACHE II score) was correlated with admission levels of superoxide radicals and antioxidants (superoxide dismutase (SOD), catalase and glutathione peroxidase). Levels were compared with general surgery controls (n = 10). Superoxide and antioxidant levels at admission (day 1) and post-operative days 3 and 5/7 were then correlated with outcome. Results: Nine of the 45 patients died (20% mortality) and 17 patients had complications (47% morbidity). The mean APACHE II score on admission was significantly higher among non-survivors than survivors (p < 0.01). The APACHE II score on admission correlated with the level of free radicals (r = 0.477, p < 0.01), catalase (r = –0.489, p < 0.01) and SOD (r = –0.357, p < 0.05). Admission superoxide levels were higher and antioxidant levels lower in peritonitis patients than controls. Levels did not significantly change following surgical intervention and post-operative levels did not correlate with outcome. Conclusion: The levels of superoxide and antioxidants correlate with the severity of illness on admission in patients with secondary peritonitis, but serial levels following surgical intervention do not predict outcome.

Effects of Aloe vera leaf gel extract on rat peritonitis model

“…An increase in SOD activity at peritonitis and its correlation with the severity of the illness was reported before. [2627] It was concluded that, SOD itself was a stress protein and elevation of SOD in inflammation might result from higher oxygen radical levels. [27] In this study, AV significantly decreased the elevated level of Cu, Zn-SOD in peritonitis group in comparison to control group.…”

Korelasi Skor Modified Sequensial Organ Failure Assesment dengan Kadar Superoksida Dismutase dan Vitamin D Serum pada Pasien Sepsis

“…Penelitian pada pasien peritonitis menggunakan skor APACHE II dijumpai korelasi negatif dengan SOD (p<0,05). 19 Penelitian lain menunjukkan skor MSOFA dan SOFA lebih baik dibanding dengan APACHE II dalam memprediksi mortalitas pada pasien ruang rawat intensif bedah. 20 Dari pembahasan di atas, peneliti menyadari masih ada kekurangan dari penelitian ini.…”

Sulphur amino acids and immune functions

“…NAC therapy has been shown to restore intracellular glutathione (Paterson et al, 2003), but this should be considered in the light of a more detailed investigation of blood peroxides and antioxidant enzyme defences in patients with peritonitis which failed to confirm that disordered antioxidant defences were prognostic (Kumar et al, 2007). One clinical trial has shown that supplementation with two other antioxidants related to glutathione, α-tocopherol and ascorbate, reduced the risk of progression to MSOF by 57% (Nathens et al, 2002), whereas a large trial of glutamine and selenium supplementation showed no effect (Andrews et al, 2011).…”