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A pilot study of hyperoxemia on neurological injury, inflammation and oxidative stress
Author(s) -
Lång M.,
Skrifvars M. B.,
Siironen J.,
Tanskanen P.,
AlaPeijari M.,
Koivisto T.,
Djafarzadeh S.,
Bendel S.
Publication year - 2018
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/aas.13093
Subject(s) - medicine , enolase , oxidative stress , hyperoxia , reactive oxygen species , traumatic brain injury , gastroenterology , mechanical ventilation , brain damage , anesthesia , fraction of inspired oxygen , lung , biochemistry , chemistry , immunohistochemistry , psychiatry
Background Normobaric hyperoxia is used to alleviate secondary brain ischaemia in patients with traumatic brain injury ( TBI ), but clinical evidence is limited and hyperoxia may cause adverse events. Methods An open label, randomised controlled pilot study comparing blood concentrations of reactive oxygen species ( ROS ), interleukin 6 ( IL ‐6) and neuron‐specific enolase ( NSE ) between two different fractions of inspired oxygen in severe TBI patients on mechanical ventilation. Results We enrolled 27 patients in the Fi O 2 0.40 group and 38 in the Fi O 2 0.70 group; 19 and 23 patients, respectively, completed biochemical analyses. In baseline, there were no differences between Fi O 2 0.40 and Fi O 2 0.70 groups, respectively, in ROS (64.8 nM [22.6–102.1] vs. 64.9 nM [26.8–96.3], P = 0.80), IL ‐6 (group 92.4 pg/ml [52.9–171.6] vs. 94.3 pg/ml [54.8–133.1], P = 0.52) or NSE (21.04 ug/l [14.0–30.7] vs. 17.8 ug/l [14.1–23.9], P = 0.35). ROS levels did not differ at Day 1 (24.2 nM [20.6–33.5] vs. 29.2 nM [22.7–69.2], P = 0.10) or at Day 2 (25.4 nM [21.7–37.4] vs. 47.3 nM [34.4–126.1], P = 0.95). IL ‐6 concentrations did not differ at Day 1 (112.7 pg/ml [65.9–168.9) vs. 83.9 pg/ml [51.8–144.3], P = 0.41) or at Day 3 (55.0 pg/ml [34.2–115.6] vs. 49.3 pg/ml [34.4–126.1], P = 0.95). NSE levels did not differ at Day 1 (15.9 ug/l [9.0–24.3] vs. 15.3 ug/l [12.2–26.3], P = 0.62). There were no differences between groups in the incidence of pulmonary complications. Conclusion Higher fraction of inspired oxygen did not increase blood concentrations of markers of oxidative stress, inflammation or neurological injury or the incidence of pulmonary complications in severe TBI patients on mechanical ventilation.