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Elevated serum bleomycin-detectable iron concentrations in patients with sepsis syndrome

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Abstract

Objective

To determine serum bleomycin-detectable ‘free’ iron in patients with septic shock and to relate these findings to both outcome and a marker of free radical damage.

Design

A prospective observational study.

Setting

A nine-bed intensive care unit in a university teaching hospital.

Patients

Sixteen consecutive patients with septic shock, defined as: (1) Clinical evidence of acute infection; (2) hypo- or hyperthermia (<35.6° or >38.3°C); (3) tachypnoea (>20 breaths/min or ventilated); (4) tachycardia (>90 beats min); (5) shock (systolic pressure <90 mmHg) or on inotropes. Fourteen patients also had secondary organ dysfunction.

Measurements and results

Bleomycin-detectable iron concentrations were elevated in all patients (37.2±11.0 μmol/l vs 5.1±3.3 μmol/l in healthy subjects,P<0.0001), but there was no difference between patients who died and those who survived (39.2±9.3 and 36.2±12.3 μmol/l, respectively). Thiobarbituric acid reactive substances 9an index of lipid peroxidation) were higher in those who died (3.33±2.29 μmol/l) than in the surviving patients (0.99±0.14 μmol/l,P<0.01) or healthy subjects (0.92±0.39 μmol/l,P<0.01). Free iron did not correlate with thiobarbituric acid-reactive substances. However, a significant correlation was found between lipid peroxidation and clinical severity (APACHE II) score (r=0.54,P<0.05).

Conclusions

The present study provides evidence of lipid peroxidation in patients who die with septic shock. The data suggest that ironcatalysed hydroxyl radical generation does not form an important contribution to this lipid peroxidation in patients with sepsis.

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References

  1. Goode HF, Cowley HC, Walker BE, Howdle PD, Webster NR (1995) Decreased antioxidant status and increased lipid peroxidation in patients with septic shock and secondary oxygen dysfunction. Crit Care Med 23:646–651

    Google Scholar 

  2. Richard M, Lemonnier C, Thibault M, Couturier M, Auzepy P (1990) Vitamin E deficiency and lipoperoxidation during adult respiratory distress syndrome. Crit Care Med 18:4–9

    Google Scholar 

  3. Downing C, Piripitsi A, Bodenham A, Schorah CJ (1993) Plasma vitamin C in critically ill patients (abstract). Proc Nutr Soc 52:314A

    Google Scholar 

  4. Baldwin SR, Grum CM, Boxer LA, et al. (1986) Oxidant activity in expired breath of patients with adult respiratory distress syndrome. Lancet 1:11–13

    Google Scholar 

  5. Mathru M, Rooney MW, Dries DJ, Hirsch LJ, Barnes L, Tobin MJ (1994) Urine hydrogen peroxide during adult respiratory distress syndrome. Chest 105:232–236

    Google Scholar 

  6. Webster NR, Nunn JF (1988) Molecular structure of free radicals and their importance in biological reactions. Br J Anaesth 60:98–108

    Google Scholar 

  7. Bone RC, Fisher CJ, Clemmer TP, Slotman GJ, Metz CA, Balk RA et al. (1989) Sepsis syndrome: a valid clinical entity. Crit Care Med 17:389–393

    Google Scholar 

  8. Knaus WA, Draper EA, Wagner DP, Zimmerman JE (1985) APACHE II: severity of disease classification system. Crit Care Med 13:818–829

    Google Scholar 

  9. Gutteridge JMC, Rowley DA, Halliwell B (1981) Superoxide-dependent formation of hydroxyl radials in the presence of iron salts. Detection of ‘free’ iron in biological systems by using bleomycin-dependent degradation of DNA. Biochem J 199:263–265

    Google Scholar 

  10. Yagi K (1976) A simple fluorometric assay for lipoperoxide in blood plasma. Biochem Med Metab Biol 15:212–216

    Google Scholar 

  11. Slater TF (1984) Overview of methods used for detecting lipid peroxidation. Methods Enzymol 105:283–293

    Google Scholar 

  12. Koj A (1985) Definition, classification and biological functions of acute phase proteins. In: Gordon AH, Koj A (eds) The acute phase response to injury and infection. Elsevier Science Amsterdam. pp 139–158

    Google Scholar 

  13. Halliwell B, Gutteride, JMC (1990) Role of free radicals and catalytic metal ions in human disease: an overview. In: Packer L, Glazer AN (eds) Methods in enzymology, vol 186. Academic Press, London, pp 1–85

    Google Scholar 

  14. Windsor ACJ, Mullen PG, Fowler AA, Sugerman HJ (1993) Role of the neutrophil in adult respiratory distress syndrome. Br J Surg 80:10–17

    Google Scholar 

  15. Simms HH, D'Amico R (1994) Polymorphonuclear leukocyte dysregulation during the systemic inflammatory distress syndrome. Blood 83:1398–1407

    Google Scholar 

Download references

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Authors and Affiliations

  1. Anaesthesia and Intensive Care, University of Aberdeen, Department of Medicine and Therapeutics, Foresterhill, AB9 2ZD, Aberdeen, UK

    H. F. Galley & N. R. Webster

Authors
  1. H. F. Galley
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  2. N. R. Webster
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Galley, H.F., Webster, N.R. Elevated serum bleomycin-detectable iron concentrations in patients with sepsis syndrome. Intensive Care Med 22, 226–229 (1996). https://doi.org/10.1007/BF01712241

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  • DOI: https://doi.org/10.1007/BF01712241

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