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Controlling Oxidative Stress as a Potential Tool for Perioperative Management to Reduce Morbidity After Surgical Trauma

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Diet and Nutrition in Critical Care

Abstract

Oxidative stress is considered to increase in proportion to the severity of surgical trauma. However, the biochemical marker which best reflects the severe oxidative stress following major surgery, such as esophagectomy, has not been determined. Multiple studies have concluded that there is a reduction in antioxidative activities in response to surgical trauma. Evidence from animal studies has shown that oxidative stress is associated with postoperative complications. Clinical studies have suggested that the oxidative stress after ischemia-reperfusion injury, caused by surgery for abdominal aortic aneurysm and coronary artery bypass graft operation, is associated with subsequent surgical morbidities. A recent international, randomized, blinded trial involving critically ill patients with multiorgan failure revealed that supplementation with antioxidants, including selenium, zinc, beta-carotene, vitamin E, and vitamin C, showed no therapeutic benefits. In contrast, supplemental l-carnitine, glutamine, and coenzyme Q10 showed promising activity with the potential to reduce oxidative stress induced by surgical trauma or catheter angioplasty. Although there are still many unresolved issues, such as the optimum dose or the most appropriate antioxidant combination to treat a particular condition, controlling oxidative stress may be another potential tool for perioperative management to reduce morbidity after severe surgical trauma.

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Abbreviations

8-epiPGF2α:

8-epi-prostaglandin F2 alpha

AAA:

Abdominal aortic aneurysm

AKI:

Acute kidney injury

ALC:

Acetyl-l-carnitine

ARE:

Arylesterase

CARR U:

Carratelli units

CRT:

Chemoradiotherapy

FRAP:

Ferric-reducing ability of plasma

ICU:

Intensive care unit

IED:

Immune-enhanced diet

LC:

Laparoscopic cholecystectomy

MDA:

Malondialdehyde

MDS:

Myelodysplastic syndrome

NAC:

N-acetylcysteine

NADPH:

Nicotinamide adenine dinucleotide phosphate

NO:

Nitric oxide

OC:

Open cholecystectomy

oLDL:

Oxidized low-density lipoprotein

OXY:

OXY-adsorbent test

POD:

Postoperative day

PON:

Paraoxonase

PUFA:

Polyunsaturated fatty acids

ROM:

Reactive oxygen metabolites

ROS:

Reactive oxygen species

sNOX2-dp:

Soluble NOX2-derived peptide

SOD:

Superoxide dismutase

TBARS:

Thiobarbituric acid reactive substances

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Authors and Affiliations

  1. Department of Surgery, Eiju General Hospital, 2-23-16 Higashiueno, Taitou-ku, Tokyo, 110-8645, Japan

    Satoshi Aiko

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  1. Satoshi Aiko
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Correspondence to Satoshi Aiko .

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Editors and Affiliations

  1. Royal Free London Hospitals, Barnet General Hospital, London, UK

    Rajkumar Rajendram

  2. Division of Diabetes & Nutritional Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, UK

    Rajkumar Rajendram

  3. King Khalid University Hospital, King Saud University Medical City, Riyadh, Saudi Arabia

    Rajkumar Rajendram

  4. Department of Nutrition and Dietetics, Division of Diabetes & Nutritional Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, UK

    Victor R. Preedy

  5. Department of Biomedical Sciences, Faculty of Science & Technology, University of Westminster, London, UK

    Vinood B. Patel

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Aiko, S. (2015). Controlling Oxidative Stress as a Potential Tool for Perioperative Management to Reduce Morbidity After Surgical Trauma. In: Rajendram, R., Preedy, V.R., Patel, V.B. (eds) Diet and Nutrition in Critical Care. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7836-2_117

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  • DOI: https://doi.org/10.1007/978-1-4614-7836-2_117

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