Department of Critical Care Unit, University Hospital Arnau de Vilanova, University of Lleida-IRBLleida, Lleida, Spain.
Department of Experimental Medicine, Faculty of Medicine, University of Lleida-IRBLleida, Lleida, Spain.
PLoS One. 2018 Oct 11;13(10):e0205519. doi: 10.1371/journal.pone.0205519. eCollection 2018.
Though circulating antioxidant capacity in plasma is homeostatically regulated, it is not known whether acute stressors (i.e. trauma) affecting different anatomical locations could have quantitatively different impacts. For this reason, we evaluated the relationship between the anatomical location of trauma and plasma total antioxidant capacity (TAC) in a prospective study, where the anatomical locations of trauma in polytraumatic patients (n = 66) were categorized as primary affecting the brain -traumatic brain injury (TBI)-, thorax, abdomen and pelvis or extremities. We measured the following: plasma TAC by 2 independent methods, the contribution of selected antioxidant molecules (uric acid, bilirubin and albumin) to these values and changes after 1 week of progression. Surprisingly, TBI lowered TAC (919 ± 335 μM Trolox equivalents (TE)) in comparison with other groups (thoracic trauma 1187 ± 270 μM TE; extremities 1025 ± 276 μM TE; p = 0.004). The latter 2 presented higher hypoxia (PaO2/FiO2 272 ± 87 mmHg) and hemodynamic instability (inotrope use required in 54.5%) as well. Temporal changes in TAC are also dependent on anatomical location, as thoracic and extremity trauma patients' TAC values decreased (1187 ± 270 to 1045 ± 263 μM TE; 1025 ± 276 to 918 ± 331 μM TE) after 1 week (p < 0.01), while in TBI these values increased (919 ± 335 to 961 ± 465 μM TE). Our results show that the response of plasma antioxidant capacity in trauma patients is strongly dependent on time after trauma and location, with TBI failing to induce such a response.
尽管血浆中的循环抗氧化能力是处于体内平衡调节的，但目前尚不清楚影响不同解剖部位的急性应激源（例如创伤）是否会产生定量不同的影响。出于这个原因，我们在一项前瞻性研究中评估了创伤的解剖部位与创伤患者（n = 66）的血浆总抗氧化能力（TAC）之间的关系，其中创伤的解剖部位分为主要影响大脑-创伤性脑损伤（TBI）-、胸部、腹部和骨盆或四肢。我们测量了以下内容：通过 2 种独立的方法测量血浆 TAC，选择抗氧化分子（尿酸、胆红素和白蛋白）对这些值的贡献以及在 1 周进展后的变化。令人惊讶的是，与其他组相比，TBI 降低了 TAC（919 ± 335 μM Trolox 等效物（TE））（胸部创伤 1187 ± 270 μM TE；四肢 1025 ± 276 μM TE；p = 0.004）。后两者还表现出更高的缺氧（PaO2/FiO2 272 ± 87 mmHg）和血流动力学不稳定（需要使用 54.5%的正性肌力药）。TAC 的时间变化也取决于解剖部位，因为胸部和四肢创伤患者的 TAC 值在 1 周后下降（1187 ± 270 至 1045 ± 263 μM TE；1025 ± 276 至 918 ± 331 μM TE）（p < 0.01），而在 TBI 中这些值增加（919 ± 335 至 961 ± 465 μM TE）。我们的结果表明，创伤患者血浆抗氧化能力的反应强烈依赖于创伤后时间和部位，TBI 未能诱导这种反应。
