PMID- 33213070
OWN - NLM
STAT- MEDLINE
DCOM- 20210514
LR  - 20210514
IS  - 1648-9144 (Electronic)
IS  - 1010-660X (Print)
IS  - 1010-660X (Linking)
VI  - 56
IP  - 11
DP  - 2020 Nov 17
TI  - Usefulness of Antioxidants as Adjuvant Therapy for Septic Shock: A Randomized 
      Clinical Trial.
LID - 10.3390/medicina56110619 [doi]
LID - 619
AB  - Background and objectives: Oxidative stress (OS) participates in the 
      pathophysiology of septic shock, which leads to multiple organ failure (MOF), 
      ischemia-reperfusion injury, and acute respiratory distress syndrome. Therefore, 
      antioxidants have been proposed as therapy. Here, we evaluated the effect of 
      antioxidant treatments in patients with septic shock with MOF and determined 
      levels OS before and after treatment. This study was a randomized, controlled, 
      triple-masked, and with parallel assignment clinical trial with a control group 
      without treatment. Materials and Methods: It included 97 patients of either sex 
      with septic shock. 5 treatments were used each in an independent group of 18 
      patients. Group 1 received vitamin C (Vit C), group 2 vitamin E (Vit E), group 3 
      n-acetylcysteine (NAC), group 4 melatonin (MT), and group 5 served as control. 
      All antioxidants were administered orally or through a nasogastric tube for five 
      days as an adjuvant to the standard therapy. Results: The results showed that all 
      patients presented MOF due to sepsis upon admission and that the treatment 
      decreased it (p = 0.007). The antioxidant treatment with NAC increased the total 
      antioxidant capacity (p < 0.05). The patients that received Vit C had decreased 
      levels of the nitrate and nitrite ratio (p < 0.01) and C-reactive protein levels 
      (p = 0.04). Procalcitonin levels were reduced by Vit E (p = 0.04), NAC (p = 
      0.001), and MT (p = 0.04). Lipid-peroxidation was reduced in patients that 
      received MT (p = 0.04). Conclusions: In conclusion, antioxidant therapy 
      associated with standard therapy reduces MOF, OS, and inflammation in patients 
      with septic shock.
FAU - Aisa-Alvarez, Alfredo
AU  - Aisa-Alvarez A
AD  - Critical Care Department, American British Cowdray (ABC) Medical Center, I.A.P. 
      ABC Sur 136 No. 116 Col. las Americas, Mexico City 01120, Mexico.
FAU - Soto, Maria Elena
AU  - Soto ME
AUID- ORCID: 0000-0003-1332-2888
AD  - Critical Care Department, American British Cowdray (ABC) Medical Center, I.A.P. 
      ABC Sur 136 No. 116 Col. las Americas, Mexico City 01120, Mexico.
AD  - Immunology Department Instituto Nacional de Cardiologia Ignacio Chavez, Juan 
      Badiano 1, Seccion XVI, Tlalpan, Mexico City 14080, Mexico.
FAU - Guarner-Lans, Veronica
AU  - Guarner-Lans V
AUID- ORCID: 0000-0002-2655-7590
AD  - Physiology Department Instituto Nacional de Cardiologia Ignacio Chavez, Juan 
      Badiano 1, Seccion XVI, Tlalpan, Mexico City 14080, Mexico.
FAU - Camarena-Alejo, Gilberto
AU  - Camarena-Alejo G
AD  - Critical Care Department, American British Cowdray (ABC) Medical Center, I.A.P. 
      ABC Sur 136 No. 116 Col. las Americas, Mexico City 01120, Mexico.
FAU - Franco-Granillo, Juvenal
AU  - Franco-Granillo J
AD  - Critical Care Department, American British Cowdray (ABC) Medical Center, I.A.P. 
      ABC Sur 136 No. 116 Col. las Americas, Mexico City 01120, Mexico.
FAU - Martinez-Rodriguez, Enrique A
AU  - Martinez-Rodriguez EA
AD  - Critical Care Department, American British Cowdray (ABC) Medical Center, I.A.P. 
      ABC Sur 136 No. 116 Col. las Americas, Mexico City 01120, Mexico.
FAU - Gamboa Avila, Ricardo
AU  - Gamboa Avila R
AD  - Physiology Department Instituto Nacional de Cardiologia Ignacio Chavez, Juan 
      Badiano 1, Seccion XVI, Tlalpan, Mexico City 14080, Mexico.
FAU - Manzano Pech, Linaloe
AU  - Manzano Pech L
AD  - Cardiovascular Biomedicine Department Instituto Nacional de Cardiologia Ignacio 
      Chavez, Juan Badiano 1, Seccion XVI, Tlalpan, Mexico City 14080, Mexico.
FAU - Perez-Torres, Israel
AU  - Perez-Torres I
AUID- ORCID: 0000-0001-6510-2954
AD  - Cardiovascular Biomedicine Department Instituto Nacional de Cardiologia Ignacio 
      Chavez, Juan Badiano 1, Seccion XVI, Tlalpan, Mexico City 14080, Mexico.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20201117
PL  - Switzerland
TA  - Medicina (Kaunas)
JT  - Medicina (Kaunas, Lithuania)
JID - 9425208
RN  - 0 (Antioxidants)
RN  - 1406-18-4 (Vitamin E)
RN  - PQ6CK8PD0R (Ascorbic Acid)
SB  - IM
MH  - *Antioxidants/therapeutic use
MH  - Ascorbic Acid/therapeutic use
MH  - Humans
MH  - Lipid Peroxidation
MH  - *Shock, Septic/drug therapy
MH  - Vitamin E/therapeutic use
PMC - PMC7698534
OTO - NOTNLM
OT  - antioxidant therapy
OT  - multiple organ failure
OT  - oxidative stress
OT  - shock septic
COIS- The authors declare no conflict of interest.
EDAT- 2020/11/21 06:00
MHDA- 2021/05/15 06:00
PMCR- 2020/11/17
CRDT- 2020/11/20 01:02
PHST- 2020/10/15 00:00 [received]
PHST- 2020/11/12 00:00 [revised]
PHST- 2020/11/13 00:00 [accepted]
PHST- 2020/11/20 01:02 [entrez]
PHST- 2020/11/21 06:00 [pubmed]
PHST- 2021/05/15 06:00 [medline]
PHST- 2020/11/17 00:00 [pmc-release]
AID - medicina56110619 [pii]
AID - medicina-56-00619 [pii]
AID - 10.3390/medicina56110619 [doi]
PST - epublish
SO  - Medicina (Kaunas). 2020 Nov 17;56(11):619. doi: 10.3390/medicina56110619.