Investigation of Oxidative Stress Parameters and Prolidase Enzyme Level Change in Mechanically Ventilated Patients in Intensive Care Unit

Abstract

Abstract:

Background: Mechanical ventilation therapy can increase oxidative stress in the lungs. Oxidative stress may cause damage to collagen, which is an important component of the extracellular matrix in the lungs. In this study, total oxidative and antioxidative status in serum and bronchoalveolar lavage were determined in patients who underwent mechanical ventilation. It was investigated whether the oxidative damage due to mechanical ventilation causes a collagen damage in the lung tissue, and if there is a collagen damage in the lungs, how the prolidase enzyme level, which is one of the indicators of collagen damage, is affected.

Materials and Methods: The study included 26 adult patients aged 30-70 years, who were treated with mechanical ventilation for cerebrovascular disease-ischemia and cerebrovascular disease-hemorrhage in the intensive care unit and did not have primary lung pathology. Total oxidant level to determine oxidative stress levels, total antioxidant level to determine antioxidant capacity, and prolidase enzyme activity were studied in blood and bronchoalveolar lavage samples taken from patients on days 1-3-5-7. The oxidative stress index was found by calculating the total oxidant level/ total antioxidant level ratio.

Results: The longer the patients stay in the intensive care unit and the longer they are connected to the mechanical ventilator, in the serum; It was observed that total antioxidant levels decreased significantly (p<0.001), total oxidant level and oxidative stress index increased significantly (p<0.01), and prolidase level increased significantly (p<0.001). Also In bronchoalveolar lavage; It was determined that total antioxidant levels decreased significantly (p<0.001), total oxidant level and oxidative stress index increased significantly (p<0.001), and prolidase level decreased significantly (p<0.001).

Conclusion: In intensive care patients, oxidative stress increases in serum and bronchoalveolar lavage depending on the duration of mechanical ventilation treatment, and accordingly, collagen metabolism is also affected. Treatments aimed at reducing oxidative stress will be beneficial in preventing complications related to mechanical ventilation and reducing mortality. It would be appropriate to support our study with further clinical studies.