The role of preoperative antioxidant status in the development of the Systemic Inflammatory Response Syndrome in elective aortic aneurysm repair
The role of preoperative antioxidant status in the development of the Systemic Inflammatory Response Syndrome in elective aortic aneurysm repair
The aim of this thesis was to investigate the role of the preoperative antioxidant status in inflammatory response using elective abdominal aortic aneurysm patients as a model. 20 patients undergoing elective abdominal aortic aneurysm repair were enrolled following ethnics committee approval and informed consent. Blood samples were collected pre-operatively, before and post clamp release and postoperatively to day 5.
Interleukin-6, 8 and 10 were analysed using an Enzyme Amplified Sensitivity Immunoassay (EASIA). The Acute Physiology Age and Chronic Health Evaluation (APACHE) II score at 24 hours and daily Sequential organ failure scores (SOFA) were calculated.
The patients had a median age of 71.8 (range 62-77), with a median APACHE II score of 16 (3.6), a predicted in hospital mortality of 10.6% (11) and an ICU stay of 25 (30.8) hours. 19 patients survived to hospital discharge. The only antioxidant measured that showed any effect was GSH. Pre-operative GSH is inversely related to the CRP at 72 hours (r=0.515, P=0.02) and also CRP area under the curve (r=0.471, P=0.038). Similarly, the SOFA score has a negative correlation at 24 hours (rs=0.453, P=0.045) and SOFA area under the curve (rs=0.560, P=0.010). Though APACHE II does not quite reach significance (rs=0.459, p=0.055) it does show a similar negative trend as SOFA score. There was a significant difference between the mean GSH in patients with a phase angle < or > 5.3o (2.90 mmol/l v 3.64 mmol/l t=-3.791 (df 18) p=0.001).
The results would suggest that GSH may be pivotal in modulating the inflammatory response. The enhancement of preoperative GSH may therefore ameliorate the adverse effects of inflammation and would be worth further study.
University of Southampton
Boyes, Simon Ashley
cc1e9271-78f5-4c63-a17b-b296d38da6d0
2005
Boyes, Simon Ashley
cc1e9271-78f5-4c63-a17b-b296d38da6d0
Boyes, Simon Ashley
(2005)
The role of preoperative antioxidant status in the development of the Systemic Inflammatory Response Syndrome in elective aortic aneurysm repair.
University of Southampton, Doctoral Thesis.
Record type:
Thesis
(Doctoral)
Abstract
The aim of this thesis was to investigate the role of the preoperative antioxidant status in inflammatory response using elective abdominal aortic aneurysm patients as a model. 20 patients undergoing elective abdominal aortic aneurysm repair were enrolled following ethnics committee approval and informed consent. Blood samples were collected pre-operatively, before and post clamp release and postoperatively to day 5.
Interleukin-6, 8 and 10 were analysed using an Enzyme Amplified Sensitivity Immunoassay (EASIA). The Acute Physiology Age and Chronic Health Evaluation (APACHE) II score at 24 hours and daily Sequential organ failure scores (SOFA) were calculated.
The patients had a median age of 71.8 (range 62-77), with a median APACHE II score of 16 (3.6), a predicted in hospital mortality of 10.6% (11) and an ICU stay of 25 (30.8) hours. 19 patients survived to hospital discharge. The only antioxidant measured that showed any effect was GSH. Pre-operative GSH is inversely related to the CRP at 72 hours (r=0.515, P=0.02) and also CRP area under the curve (r=0.471, P=0.038). Similarly, the SOFA score has a negative correlation at 24 hours (rs=0.453, P=0.045) and SOFA area under the curve (rs=0.560, P=0.010). Though APACHE II does not quite reach significance (rs=0.459, p=0.055) it does show a similar negative trend as SOFA score. There was a significant difference between the mean GSH in patients with a phase angle < or > 5.3o (2.90 mmol/l v 3.64 mmol/l t=-3.791 (df 18) p=0.001).
The results would suggest that GSH may be pivotal in modulating the inflammatory response. The enhancement of preoperative GSH may therefore ameliorate the adverse effects of inflammation and would be worth further study.
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Published date: 2005
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Local EPrints ID: 465961
URI: http://eprints.soton.ac.uk/id/eprint/465961
PURE UUID: 75048f42-3b0c-46bc-a4bc-0477fbfc5677
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Date deposited: 05 Jul 2022 03:47
Last modified: 16 Mar 2024 20:27
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Simon Ashley Boyes
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