The Effects of Antioxidants and Hyperbaric Oxygenation at Severe Thermal Injury: a Prospective Study

Abstract

INTRODUCTION. Severe thermal injury (STI) characterized, among others, by hypoxia and oxidative stress (OS). The possibility of maintaining the antioxidant system through the antioxidants usage is proposed, but their effectiveness and duration are debatable issues. On the other hand, correction of OS at STI is theoretically possible by hyperbaric oxygenation (HBO) sessions, but there is a need to assess the benefit-risk ratio. AIM. Investigate the effect of antioxidants and hyperbaric oxygenation sessions on the course of oxidative stress at severe thermal injury. MATERIALS AND METHODS. This study involved conditionally healthy individuals (n = 25), and patients with STI (n = 31), randomized into 3 groups: standard methods (n = 11), supplemented with antioxidants (daily injecting of 250 g vitamin C, 1.494 g “Cernevit” and 10 ml “Addamel N” during 14 days, n = 11) or HBO sessions (50–60 minutes in pressure chambers BLKS-30, BLKS-307/1 in the “low dose” at 1.3 Ata, n = 9). Plasma and erythrocytes were evaluated for free radical oxidation (FPO) and total antioxidant activity, malonic dialdehyde (MDA) concentration, activity of superoxide dismutase (SOD), catalase, and glutathione reductase. RESULTS AND DISCUSSION. At the antioxidant usage was found SOD activity increase by 11 % (p 0.01) on the second day, a decrease in FROer by 13 % (p = 0.012) on the 9th day, and MDAer by 13 % (p = 0.036) on the 6th day. In the HBO group, there was 9 % increase in SOD activity (p = 0.038) after the first session, an increase in glutathione reductase activity by 15 % (p = 0.028) by the 9th day. Thus, it is possible to pre-limit the period of potentially favorable use of antioxidants and HBO, which contributes to the maximum therapeutic effect. The negative consequences caused by the use of antioxidants or HBO have not been identified in this work. CONCLUSION. The antioxidant usage at STI contributes to the growth of the antioxidant protection of erythrocytes. The HBO usage leads to an improvement in cellular respiration and antioxidant enzymes activity and does not cause a deepening of OS. The optimal duration of prescribing antioxidants is the first 6–8 days, HBO — 9–11 days from the beginning of therapy.

Keywords

• thermal injury
• hyperbaric oxygenation
• catalase
• superoxide dismutase
• glutathione reductase
• free radicals
• reductive stress
• oxidative stress