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The Beneficial Effects of Antioxidant Supplementation in Enteral Feeding in Critically Ill Patients: A Prospective, Randomized, Double‐Blind, Placebo‐Controlled Trial
Author(s) -
Crimi E,
Liguori A,
Condorelli M,
Cioffi M,
Astuto M,
Bontempo P
Publication year - 2005
Publication title -
nutrition in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.725
H-Index - 71
eISSN - 1941-2452
pISSN - 0884-5336
DOI - 10.1177/0115426505020003363
Subject(s) - medicine , tbars , enteral administration , oxidative stress , antioxidant , placebo , randomized controlled trial , isoprostane , thiobarbituric acid , gastroenterology , parenteral nutrition , lipid peroxidation , biochemistry , chemistry , alternative medicine , pathology
We investigated whether intervention with antioxidant vitamins C and E in enteral feeding influenced oxidative stress and clinical outcome in critically ill patients. Two‐hundred sixteen patients expected to require at least 10 days of enteral feeding completed the study. One‐hundred five patients received enteral feeding supplemented with antioxidants, and 111 control patients received an isocaloric formula. Plasma lipoperoxidation (by thiobarbituric acid reactive substances [TBARS] and prostaglandin F 2α isoprostane levels), low‐density lipoprotein (LDL) oxidizability, and LDL tocopherol content were determined at baseline and at the end of the 10‐day period. The clinical 28‐day outcome was also assessed. Plasma TBARS and isoprostanes were 5.33 ± 1.26 nM/mL and 312 ± 68 pg/mL, respectively, before treatment and 2.42 ± 0.61 nM/mL and 198± 42 pg/mL after intervention ( p < .01 for both comparisons). Antioxidants improved LDL resistance to oxidative stress by approximately 30% (the lag time before treatment was 87 ± 23 minutes and was 118 ± 20 minutes after treatment; p < .04). There was a significantly reduced 28‐day mortality after antioxidant intervention (45.7% in the antioxidant group and 67.5% in the regular‐feeding group; p < .05). Isoprostanes may provide a sensitive biochemical marker for dose selection in studies involving antioxidants.