McDonald Charles I, Fung Yoke Lin, Shekar Kiran, Diab Sara D, Dunster Kimble R, Passmore Margaret R, Foley Samuel R, Simonova Gabriela, Platts David, Fraser John F
Critical Care Research Group, The Prince Charles Hospital and The University of Queensland, Chermside, Queensland, Australia; Department of Anaesthesia and Perfusion, The Prince Charles Hospital, Chermside, Queensland, Australia.
Critical Care Research Group, The Prince Charles Hospital and The University of Queensland, Chermside, Queensland, Australia; Inflammation and Healing Research Cluster, School of Health and Sport Sciences, University of the Sunshine Coast, Queensland, Australia.
J Trace Elem Med Biol. 2015 Apr;30:4-10. doi: 10.1016/j.jtemb.2015.01.004. Epub 2015 Jan 17.
The purpose of this study was to determine the effects of smoke induced acute lung injury (S-ALI), extracorporeal membrane oxygenation (ECMO) and transfusion on oxidative stress and plasma selenium levels. Forty ewes were divided into (i) healthy control (n=4), (ii) S-ALI control (n=7), (iii) ECMO control (n=7), (iv) S-ALI+ECMO (n=8) and (v) S-ALI+ECMO+packed red blood cell (PRBC) transfusion (n=14). Plasma thiobarbituric acid reactive substances (TBARS), selenium and glutathione peroxidase (GPx) activity were analysed at baseline, after smoke injury (or sham) and 0.25, 1, 2, 6, 7, 12 and 24h after initiation of ECMO. Peak TBARS levels were similar across all groups. Plasma selenium decreased by 54% in S-ALI sheep (1.36±0.20 to 0.63±0.27μmol/L, p<0.0001), and 72% in sheep with S-ALI+ECMO at 24h (1.36±0.20 to 0.38±0.19, p<0.0001). PRBC transfusion had no effect on TBARS, selenium levels or glutathione peroxidase activity in plasma. While ECMO independently increased TBARS in healthy sheep to levels which were similar to the S-ALI control, the addition of ECMO after S-ALI caused a negligible increase in TBARS. This suggests that the initial lung injury was the predominant feature in the TBARS response. In contrast, the addition of ECMO in S-ALI sheep exacerbated reductions in plasma selenium beyond that of S-ALI or ECMO alone. Clinical studies are needed to confirm the extent and duration of selenium loss associated with ECMO.
本研究的目的是确定烟雾诱导的急性肺损伤（S-ALI）、体外膜肺氧合（ECMO）和输血对氧化应激及血浆硒水平的影响。将40只母羊分为以下几组：（i）健康对照组（n = 4）；（ii）S-ALI对照组（n = 7）；（iii）ECMO对照组（n = 7）；（iv）S-ALI + ECMO组（n = 8）；（v）S-ALI + ECMO + 浓缩红细胞（PRBC）输血组（n = 14）。在基线、烟雾损伤后（或假手术）以及启动ECMO后的0.25、1、2、6、7、12和24小时，分析血浆硫代巴比妥酸反应性物质（TBARS）、硒和谷胱甘肽过氧化物酶（GPx）活性。所有组的TBARS峰值水平相似。S-ALI绵羊血浆硒在24小时时下降了54%（从1.36±0.20降至0.63±0.27μmol/L，p < 0.0001），S-ALI + ECMO绵羊在24小时时下降了72%（从1.36±0.20降至0.38±0.19，p < 0.0001）。PRBC输血对血浆中的TBARS、硒水平或谷胱甘肽过氧化物酶活性没有影响。虽然ECMO单独使健康绵羊的TBARS升高至与S-ALI对照组相似的水平，但S-ALI后加用ECMO使TBARS的升高可忽略不计。这表明最初的肺损伤是TBARS反应的主要特征。相比之下，S-ALI绵羊加用ECMO使血浆硒的降低程度超过单独的S-ALI或ECMO组。需要进行临床研究以确认与ECMO相关的硒流失程度和持续时间。
