Elevated serum bleomycin-detectable iron concentrations in patients with sepsis syndrome

H. F. Galley*, N. R. Webster

*Corresponding author for this work

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Objective: To determine serum bleomycin-detectable 'free' iron in patients with septic shock and to relate these findings to both outcome and a marker of free radical damage. 

Design: A prospective observational study. 

Setting: A nine-bed intensive care unit in a university teaching hospital. 

Patients: Sixteen consecutive patients with septic shock, defined as: (1) Clinical evidence of acute infection; (2) hypo- or hyperthermia (< 35.6° or > 38.3 °C); (3) tachypnoea ( > 20 breaths/min or ventilated); (4) tachycardia ( > 90 beats min); (5) shock(systolic pressure < 90 mmHg) or on inotropes. Fourteen patients also had secondary organ dysfunction. 

Measurements and results: Bleomycin-detectable iron concentrations were elevated in all patients (37.2 ± 11.0 μmol/l vs 5.1 ± 3.3 μmol/l in healthy subjects, P < 0.0001), but there was no difference between patients who died and those who survived (39.2 ± 9.3 and 36.2 ± 12.3 μmol/l, respectively). Thiobarbituric acid reactive substances (an index of lipid peroxidation) were higher in those who died (3.33 ± 2.29 μmol/l) than in the surviving patients (0.99 ± 0.14 μmol/l, P < 0.01) or healthy subjects (0.92 ± 0.39 μmol/l, P < 0.01). Free iron did not correlate with thiobarbituric acid-reactive substances. However, a significant correlation was found between lipid peroxidation and clinical severity (APACHE II) score (r = 0.54, P < 0.05). 

Conclusions: The present study provides evidence of lipid peroxidation in patients who die with septic shock. The data suggest that iron-catalysed hydroxyl radical generation does not form an important contribution to this lipid peroxidation in patients with sepsis.

Original languageEnglish
Pages (from-to)226-229
Number of pages4
JournalIntensive Care Medicine
Volume22
Issue number3
DOIs
Publication statusPublished - 4 Apr 1996

Keywords

  • Catalytic iron
  • Free radicals
  • Lipid peroxide
  • Septicaemia

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