Effect of necrosectomy and vacuum-assisted closure (VAC) on mitochondrial function and oxidative stress markers in severe acute pancreatitis
| Autor: | Miranda-Díaz,Alejandra Guillermina, Hermosillo-Sandoval,José Manuel, Gutiérrez-Martínez,Carlos Alberto, Rodríguez-Carrizalez,Adolfo Daniel, Román-Pintos,Luis Miguel, Cardona-Muñoz,Ernesto Germán, Pacheco-Moisés,Fermín Paul, Arias-Carvajal,Óscar |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Adult
Male Pancreatitis aguda severa Vacuum Membrane Fluidity Wound Closure Techniques Estrés oxidativo Middle Aged Antioxidants Acute pancreatitis Mitochondria Oxidative Stress Pancreatectomy Pancreatitis Oxidative stress Severe acute pancreatitis Humans lcsh:Diseases of the digestive system. Gastroenterology Female Prospective Studies Disfunción mitocondrial lcsh:RC799-869 Mitochondrial dysfunction Pancreatitis aguda |
| Zdroj: | Revista Espanola de Enfermedades Digestivas, Vol 106, Iss 8, Pp 505-514 (2014) Revista Española de Enfermedades Digestivas v.106 n.8 2014 SciELO España. Revistas Científicas Españolas de Ciencias de la Salud instname |
| ISSN: | 1130-0108 |
| Popis: | Background: Severe acute pancreatitis (SAP) is associated with high morbidity and mortality. Objective: To evaluate whether necrosectomy, alone or combined with vacuum-assisted closure (VAC), has any additional beneficial effects on mitochondrial function and/or oxidative stress markers in SAP. Methods: Patients with SAP, APACHE II score > 8, and inadequate response to management in an intensive care unit were included in a prospective observational study. Sixteen underwent necrosectomy and 24 underwent necrosectomy plus VAC every 48 h. Patients were then categorized as survivors or deceased. Submitochondrial membrane fluidity of platelets and F0F1-ATPase hydrolysis were measured to represent mitochondrial function. Oxidative/nitrosative stress was measured using lipoperoxides (LPOs), nitric oxide (NO), erythrocyte membrane fluidity, and total antioxidant capacity (TAC). Results: Membrane fluidity in submitochondrial particles of platelets remained significantly increased throughout the study, and then eventually rised in deceased patients managed with necrosectomy + VAC vs. survivors (p < 0.041). Hydrolysis was significantly increased from baseline to endpoint in all patients, predominating in those who died after management with necrosectomy (p < 0.03). LPO increased in all patients, and necrosectomy was more efficient for the eventual decrease in survivors (p < 0.039). NO was found to be increased for the baseline-endpoint result among both survivors and deceased patients with both management options. Erythrocyte membrane fluidity was increased in survivors managed with necrosectomy + VAC, and eventually returned to normal (p < 0.045). TAC was found to be consumed in all patients for the duration of the study. Conclusions: Mitochondrial dysfunction and oxidative/nitrosative stress with significant systemic antioxidant consumption were found. Necrosectomy was more efficient and better cleared LPOs. Necrosectomy + VAC improved erythrocyte membrane fluidity and increased survival. |
| Databáze: | OpenAIRE |
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