RT Journal Article
SR Electronic
T1 Influence of spontaneous breathing on systemic oxidative stress during ventilator weaning
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P4918
VO 42
IS Suppl 57
A1 Jacobo Sellares
A1 Hugo Loureiro
A1 Miquel Ferrer
A1 Mònica Vila-Ubach
A1 Esther Barreiro
A1 Antoni Torres
YR 2013
UL http://erj.ersjournals.com/content/42/Suppl_57/P4918.abstract
AB RationaleAs the spontaneous breathing trial (SBT) could represent a major cardiopulmonar stress that could be associated with an increased oxidative stress, we assessed the imbalance of systemic oxidants and antioxidants during a SBT in a mixed populaton of ventilated patients and compare those with SBT failure and success.MethodsA prospective clinical study was conducted in 89 patients under mechanical ventilation (MV). During the first SBT, blood samples were drawn before, at the end and 24 hours after the SBT. An additional sample from a control group of patients (n=31) who presented respiratory failure without requirement of ventilator support was also obtained. Samples were processed for the assessment of oxidative stress as measured using several markers: oxidized and nitrated proteins, malondialdehyde (MDA), and oxidized DNA (8-OHdG), and the reduced antioxidant glutathione (GSH).ResultsBaseline levels of oxidative stress markers were similar in SBT failure (n= 33) and success (n= 56). Systemic levels of protein carbonylation and nitration, and 8-OHdG significantly decreased during SBT in both failure and success groups of patients. MDA levels were increased in SBT failure (p = 0.04) patients, but not in the SBT success group (p=0.29). Protein tyrosine nitration and 8-OHdG levels were higher during MV than those observed in patients non-exposed to MV.ConclusionsThe liberation of MV during SBT was associated with a decrease in oxidative stress markers, except for MDA, which increased in SBT failure patients. These results suggest that systemic oxidative stress seems to be influenced by MV rather than by the outcome of the SBT during ventilator weaning.