Antioxidant therapy in critical care—Is the microcirculation the primary target?

摘要: This review presents the rationale for therapeutic use of antioxidants in treating critically ill patients; it is not a systematic clinical evidence that has been assessed recently by others. Clinical and nonclinical presented to support notion natural are value cardiovascular shock. Oxidative stress major promoter mediator systemic inflammatory response. The microcirculation particularly susceptible oxidative causes hemodynamic instability, leading multiple organ failure due response syndrome. Vitamin C antioxidant used experimentally demonstrate as key pathophysiologic factor septic Pharmacologic studies reveal vitamin (as ascorbate), at supraphysiologic doses, significantly affects bioavailability nitric oxide during acute inflammation, including inhibiting synthetase induction. Parenteral high-dose inhibits endotoxin-induced endothelial dysfunction vasohyporeactivity humans reverses sepsis-induced suppression microcirculatory control rodents. In severe burn injury, both animals patients, parenteral reduces resuscitation fluid volumes. Therefore, significant body pharmacologic sound preliminary supports biological feasibility using exemplary antioxidant, C, treatment ill.