Elbaradey Ghada Fouad, Elshmaa Nagat Sayed, Hodeib Hossam
Department of Anesthesia and Surgical Intensive Care Unit, Tanta University, Tanta, Egypt.
Department of Clinical Pathology, Tanta University, Tanta, Egypt.
J Anaesthesiol Clin Pharmacol. 2016 Oct-Dec;32(4):465-469. doi: 10.4103/0970-9185.194770.
Sepsis is a complex rapidly progressive infectious disease that remain a major cause of morbidity and mortality in surgical patients and trauma victims. Edaravone a novel free radical scavenger was approved in 2001 in Japan for treatment of acute cerebral and myocardial infarction. Hence, in this work we attempt to evaluate its role in cases of septic peritonitis (SP).
This is a prospective randomized observer-blinded study carried out in surgical Intensive Care Unit (ICU) after approval by Hospital Ethical Committee. After admission to ICU patients were randomly divided into two groups of thirty patients each-Group (C): Control group managed according to the routine protocol of sepsis and Group (E): Edaravone treated SP managed according to the routine protocol of sepsis + edaravone at dose of 30 mg/12 h intravenous infusion for 2 weeks. All patients were monitored for invasive blood pressure, central venous pressure, heart rate, temperature, urine output, total fluid balance, and routine investigation. Blood sample was taken weekly for 2 weeks to measure the following parameters: Nuclear transcription factor kappa B activity (NFKB), mitogen-activated protein kinase (MAPK), heat shock protein 72 (HSP 72) and total antioxidant capacity (TAC).
There was significant decrease ( < 0.05) in serum level of NFKB, MAPK in Group E in comparison with Group C. While serum level of HSP 72 and TAC showed significant increase ( < 0.05) in Group E compared with Group C with better outcome.
SP treatment with edaravone could significantly improve the inflammatory and oxidative states with better patient outcomes.
脓毒症是一种复杂的、迅速进展的感染性疾病，仍然是外科患者和创伤受害者发病和死亡的主要原因。依达拉奉是一种新型自由基清除剂，于2001年在日本被批准用于治疗急性脑梗死和心肌梗死。因此，在本研究中，我们试图评估其在脓毒性腹膜炎（SP）病例中的作用。
这是一项前瞻性随机观察者盲法研究，在获得医院伦理委员会批准后，于外科重症监护病房（ICU）进行。患者入住ICU后，随机分为两组，每组30例。C组（对照组）按照脓毒症常规方案进行治疗，E组（依达拉奉治疗组）按照脓毒症常规方案+依达拉奉30mg/12h静脉输注2周进行治疗。所有患者均监测有创血压、中心静脉压、心率、体温、尿量、总液体平衡及常规检查。每周采集血样，共2周，以测量以下参数：核转录因子κB活性（NFKB）、丝裂原活化蛋白激酶（MAPK）、热休克蛋白72（HSP 72）和总抗氧化能力（TAC）。
与C组相比，E组血清NFKB、MAPK水平显著降低（<0.05）。而E组血清HSP 72和TAC水平较C组显著升高（<0.05），且预后更好。
依达拉奉治疗SP可显著改善炎症和氧化状态，患者预后更好。
