Decreased antioxidant status and increased lipid peroxidation in patients with septic shock and secondary organ dysfunction

Abstract

Objective To determine antioxidant vitamin concentrations, lipid peroxidation, and an index of nitric oxide production in patients in the intensive care unit (ICU) with septic shock and relate the findings to the presence of secondary organ failure. Design A prospective, observational study. Setting A nine-bed ICU in a University teaching hospital. Patients Sixteen consecutive patients with septic shock, defined as: a) clinical evidence of acute infection; b) hypo- or hyperthermia (38.3 degrees C); c) tachypnea (>20 breaths/min or being mechanically ventilated); d) tachycardia (>90 beats/min); e) shock (systolic pressure 2 = .42, p < .01 and r² = .48, p < .005, respectively). In the five patients from whom we were able to collect urine, nitrite excretion was increased approximate 400-fold (p < .001). Conclusions These data indicate decreased antioxidant status in the face of enhanced free radical activity, and suggest potential therapeutic strategies involving antioxidant repletion. (Crit Care Med 1995; 23:646-651)