OXYGEN-FREE RADICAL INJURY AND ITS RELATION TO BACTERIAL AND ENDOTOXIN TRANSLOCATION AFTER DELAYED FLUID RESUSCITATION - CLINICAL AND EXPERIMENTAL-STUDY

Citation
Hm. Yang et al., OXYGEN-FREE RADICAL INJURY AND ITS RELATION TO BACTERIAL AND ENDOTOXIN TRANSLOCATION AFTER DELAYED FLUID RESUSCITATION - CLINICAL AND EXPERIMENTAL-STUDY, Chinese medical journal, 110(2), 1997, pp. 118-124
Citations number
15
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Medicine, General & Internal
Journal title
ISSN journal
0366-6999
Volume
110
Issue
2
Year of publication
1997
Pages
118 - 124
Database
ISI
SICI code
0366-6999(1997)110:2<118:ORIAIR>2.0.ZU;2-P
Abstract
Objective To examine whether there is generation of oxygen free radica ls (OFR) and lipid peroxidation of cell membrane after volume replacem ent for burn shock, and to study the relationship between OFR injury a nd enterogenous endotoxemia. Methods Forty-seven burn patients were in volved in this study. Among them, 18 had delayed fluid resuscitation ( DR) and the others had early fluid resuscitation (ER) within 6 hours p ostburn. Sixty-six gnotobiotic rats were used in a collaborating exper iment as burn models. They were divided into 4 groups: sham injury (n= 6), early resuscitation (n=24), late resuscitation (n=24) and vitamins E and C treatment group (n =12). All the rats, except those in the sh am injury group, were inflicted with 40% total body surface area (TBSA ) third-degree burns. OFR was determined in the blood of patients with electron spin resonance (ESR). S/W ratio and re values of patients' e rythrocytes were measured with ESR spectrometer. Blood superoxide dism utase (SOD) and glutathione peroxidase (GSHPx) activities, malondialde hyde contents and plasma endotoxin levels were assayed. Rats were sacr ificed at the 12th, 24th, 48th and 72th hour after injury. Plasma endo toxin levels, mucosal SOD, GSHPx and malondialdehyde (MDA), as well as diamine oxidase activity of ileum were determined. Cultures of mesent eric lymph nodes (MLN), liver, spleen, heart, lung, kidney and blood w ere done.Results A significant increase in blood OFR contents and plas ma MDA, and a significant decline in blood SOD and GSHPx were found af ter resuscitation in DR group as compared with those in ER group. Both strong to weak spectra component (S/W) ratio and sc value were higher in DR group in contrast with those in ER group. Higher elevation in p lasma endotoxin level in DR group was seen. In DR group, plasma MDA co ntent was correlated with S/W ratio, re value and plasma endotoxin lev el. In rats, the level of mucosal MDA, plasma endotoxin and incidence of bacterial translocation (BT) were significantly higher. Mucosal SOD , GSHPx and diamine oxidase (DAO) activity were significantly lower in DR group as compared with those in ER group. In DR group, mucosal MDA content was negatively correlated with mucosal DAO activity, while th e latter was negatively correlated with BT. After treatment with vitam ins E and C, mucosal MDA content decreased, plasma endotoxin and BT si gnificantly declined and mucosal DAO heightened. Conclusions Tissue re perfusion might induce the production of OFR, resulting in lipid perox idation injury, especially to intestinal mucosa, and resulting in disr uption of mucosal barrier function followed by endotoxemia and BT.