Open Access Emergency Medicine (Apr 2023)
Antioxidant Role in Critically Ill Patients with Vasodilatory Shock: Does Glutathione Peroxidase Correlate to Severity of Tissue Hypoxia and Organ Failure
Abstract
Bambang Pujo Semedi,1,2 Nancy Margarita Rehatta,2 Jusak Nugraha,3 Soetjipto4 1Doctoral Program of Medical Science, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia; 2Department of Anesthesiology and Reanimation, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, East Java, 60132, Indonesia; 3Department of Clinical Pathology, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, East Java, 60132, Indonesia; 4Department of Medical Biochemistry, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, 60132, IndonesiaCorrespondence: Nancy Margarita Rehatta, Department of Anesthesiology and Reanimation, Faculty of Medicine, University Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, 60132, East Java, Indonesia, Tel +62315020251, Email rita@fk.unair.ac.idPurpose: We aimed to evaluate the antioxidant role in critically ill patients with vasodilatory shock as it relates to severity of tissue hypoxia and organ failure.Patients and Methods: An observational and prospective study was conducted in critically ill patients with vasodilatory shock. Glutathione peroxidase (GPx) levels as antioxidants were measured based on their levels in the patient’s serum. Tissue hypoxia as micro-hemodynamic status was represented by lactate levels, the macro-hemodynamic status was represented by vasoactive inotropic score (VIS) and mean arterial pressure (MAP), while organ dysfunction severity was represented by the shock index (SI), the sequential organ failure assessment (SOFA) score, and the acute physiology and chronic health evaluation (APACHE) II score.Results: Thirty-four critically ill patients with vasodilatory shock met the eligibility criteria. The mortality rate was 41.2%. Glutathione peroxidase levels did not show a significant difference between survivors and non-survivors at baseline or after 24 hours. At the initial measurement, there was a correlation between GPx and lactate levels, GPx and SOFA scores. The macrohemodynamic status was represented by VIS and MAP, which were correlated with SI.Conclusion: Glutathione peroxidase as antioxidant is related to severity of tissue hypoxia and organ failure in critically ill patients with vasodilatory shock.Keywords: glutathione peroxidase, severity, mortality, vasodilatory shock, critically ill
