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Increased Oxidants and Reduced Antioxidants in Irradiated Parenteral Nutrition Solutions May Contribute to the Inflammatory ResponseIntensive Care Unit, Johannesburg Hospital and University of the Witwatersrand, Johannesburg, South Africa, guy.richards{at}wits.ac.za
South African Breweries, Sandton, South Africa
National Institute for Occupational Health, Johannesburg, South Africa
National Institute for Occupational Health, Johannesburg, South Africa
National Institute for Occupational Health, Johannesburg, South Africa
Departments of Medicine and Pulmonology, Baragwanath Hospital and University of the Witwatersrand Johannesburg, South Africa
Medical Research Council Unit for Inflammation and Immunity, Department of Immunology, Tshwane Academic Division of the National Health Laboratory Service and Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
Haematology and Molecular Medicine Department, School of Health Sciences, Parktown, Johannesburg, South Africa
Background/Objectives: To measure reactive oxidant production and the decline in antioxidant potential in commercially available, irradiated parenteral nutrition (PN) solutions and the effect that these have on oxidant production in patients in the intensive care unit. Subjects and Methods: Vitamin E and malondialdehyde in irradiated and nonirradiated commercially available, PN solutions were measured. The PBN (
Key Words: oxidants • parenteral nutrition • irradiation • inflammation • isoprostanes
This version was published on July
1, 2009 Journal of Intensive Care Medicine, Vol. 24, No. 4,
252-260 (2009) |
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-phenyl-n-test-butylnitrone (PBN) spin trap was used to measure free radicals and TEMPOL (2,2,6,6-tetramethyl-4-hydroxy-piperidine-oxyl) was used to assess antioxidant capacity. The irradiated PN was administered (as per unit protocol) to 10 patients with gut failure and plasma and urinary isoprostanes and interleukin-6 (IL-6) were measured 1 hour preadministration, at the time of, and 1 and 2 hours postadministration of PN. Results: Irradiation reduced vitamin E significantly (P < .0025). Malondialdehyde products were present in both samples, but more so in irradiated samples (P < .0001), as were free radicals measured by PBN spin trapping. Irradiated samples had a higher scavenging capacity of TEMPOL free radical due to depletion of antioxidants in irradiated samples. Urinary isoprostanes increased at time 2 by 6.3 units relative to time 0 and by 5.23 units relative to time 1(Friedman ANOVA: P < .01413). Conclusions: Lipid hydroperoxides are formed in PN solutions and increase further following irradiation. This is associated with a significant reduction in vitamin E and antioxidant potential. The increase in urinary isoprostanes indicates a potentially proinflammatory effect of irradiated PN.