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Randomized Clinical Trial of Antioxidant Therapy Patients with Septic Shock and Organ Dysfunction in the ICU: SOFA Score Reduction by Improvement of the Enzymatic and Non-Enzymatic Antioxidant System.
Aisa-Álvarez, Alfredo; Pérez-Torres, Israel; Guarner-Lans, Verónica; Manzano-Pech, Linaloe; Cruz-Soto, Randall; Márquez-Velasco, Ricardo; Casarez-Alvarado, Sergio; Franco-Granillo, Juvenal; Núñez-Martínez, Marcela Elizabeth; Soto, María Elena.
  • Aisa-Álvarez A; Critical Care Department, American British Cowdray (ABC) Medical Center, I.A.P. ABC Sur 136 No. 116 Col. Las Américas, México City 01120, Mexico.
  • Pérez-Torres I; UNAM Master's and Doctoral Program in Medical, Dental and Health Sciences UNAM, México. Av. Universidad 3000, Coyoacán, México City 04510, Mexico.
  • Guarner-Lans V; Cardiovascular Biomedicine Department, Instituto Nacional de Cardiología Ignacio Chávez, Juan Badiano 1, Sección XVI, Tlalpan, México City 14080, Mexico.
  • Manzano-Pech L; Physiology Department, Instituto Nacional de Cardiología Ignacio Chávez, Juan Badiano 1, Sección XVI, Tlalpan, México City 14080, Mexico.
  • Cruz-Soto R; Cardiovascular Biomedicine Department, Instituto Nacional de Cardiología Ignacio Chávez, Juan Badiano 1, Sección XVI, Tlalpan, México City 14080, Mexico.
  • Márquez-Velasco R; Immunology Department, Instituto Nacional de Cardiología Ignacio Chávez, Juan Badiano 1, Sección XVI, Tlalpan, México City 14080, Mexico.
  • Casarez-Alvarado S; Immunology Department, Instituto Nacional de Cardiología Ignacio Chávez, Juan Badiano 1, Sección XVI, Tlalpan, México City 14080, Mexico.
  • Franco-Granillo J; Immunology Department, Instituto Nacional de Cardiología Ignacio Chávez, Juan Badiano 1, Sección XVI, Tlalpan, México City 14080, Mexico.
  • Núñez-Martínez ME; Critical Care Department, American British Cowdray (ABC) Medical Center, I.A.P. ABC Sur 136 No. 116 Col. Las Américas, México City 01120, Mexico.
  • Soto ME; Central Laboratory Department, ABC Hospital Observatory, Sur 136 No. 116 Col. Las Américas, México City 01120, Mexico.
Cells ; 12(9)2023 05 06.
Article in English | MEDLINE | ID: covidwho-2312262
ABSTRACT
BACKGROUND AND

AIM:

Here, we assess the effect of adjuvant antioxidant therapies in septic shock patients with organ dysfunction and their effect on the enzymatic and non-enzymatic antioxidant systems.

METHODS:

Randomized clinical trial run between 2018 and 2022. One hundred and thirty-one patients with septic shock were included in five groups with 25, 27, 24, 26 and 29 patients each. Group 1 received vitamin C (Vit C), Group 2 vitamin E (Vit E), Group 3 n-acetylcysteine (NAC), Group 4 melatonin (MT) and group 5 no treatment. All antioxidants were administered orally or through a nasogastric tube for 5 days as an adjuvant to standard therapy.

RESULTS:

All patients had multiple organ failure (MOF) and low Vit C levels. Vit C therapy decreased CRP, PCT and NO3-/NO2- but increased Vit C levels. The SOFA score decreased with MT in 75%, Vit C 63% and NAC 50% vs. controls 33% (p = 0.0001, p = 0.03 and p = 0.001 respectively). MT diminished lipid peroxidation (LPO) (p = 0.01) and improved total antioxidant capacity (TAC) (p = 0.04). Vit E increased thiol levels (p = 0.02) and tended to decrease LPO (p = 0.06). Selenium levels were decreased in the control group (p = 0.04).

CONCLUSIONS:

Antioxidants used as an adjuvant therapy in the standard treatment of septic shock decrease MOF and oxidative stress markers. They increase the TAC and thiols, and maintain selenium levels.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Selenium / Shock, Septic / Melatonin Type of study: Experimental Studies / Prognostic study / Randomized controlled trials Limits: Humans Language: English Year: 2023 Document Type: Article Affiliation country: Cells12091330

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Selenium / Shock, Septic / Melatonin Type of study: Experimental Studies / Prognostic study / Randomized controlled trials Limits: Humans Language: English Year: 2023 Document Type: Article Affiliation country: Cells12091330