Improving body antioxidant capacity with antioxidant therapies improves pulmonary outcome in COPD patients

Ahmed El-Shaer¹, Hazem M. Fawzi¹, Nahla Zakaryia^2
1 Department of Anesthesiology, Intensive Care, and Pain Management, Ain Shams University, Cairo, Egypt
² Department of Clinical Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt

Correspondence Address:
Ahmed El-Shaer
MD, Department of Anesthesiology, Intensive Care, and Pain Management, Faculty of Medicine, Ain Shams University, 11566 Cairo
Egypt

Source of Support: None, Conflict of Interest: None

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DOI: 10.7123/01.ASJA.0000417548.51708.5b

Chronic obstructive pulmonary disease (COPD) is one of the important causes of morbidity and mortality in the intensive care unit (ICU). Many studies have proven that free radicals cause damage to the pulmonary system. Antioxidants are compounds that can stop free radical-induced oxidative damage. There are two important types of antioxidants with different modes of action: enzymatic and nonenzymatic.

Our study was carried out on 60 COPD patients admitted to the ICU for respiratory causes. Patients were divided into three groups of 20 each. Group I (control group) received no antioxidant supplementation, group II received nonenzymatic antioxidant in the form of vitamins A, E, and C, group III received in addition to vitamins A, E, and C, enzymatic antioxidants in the form of selenium and zinc. Antioxidant treatment was administered for 30 days from the day of admission to the ICU. Acute physiology and chronic health evaluation II score was measured on the day of admission and after 7 days; total antioxidant capacity (TAC) was also measured on admission and on the seventh day; in addition, incidence and time of mechanical ventilation, time spent in the ICU as well as time until discharge, and, finally, mortality incidence during a 30-day period were all recorded and statistically analyzed.

TAC level increased in both groups of antioxidant supplementation after 7 days of supplementation. In addition, there were decreases in the time spent by the patients on mechanical ventilation as well as the time of ICU stay and hospital stay. There was no statistical change in the incidence of mechanical ventilation, mortality rate, or acute physiology and chronic health evaluation score after 7 days of antioxidant supplementation.

We found from our study that supplementing COPD patients in the ICU with antioxidants, either nonenzymatic (vitamins A, E, and C) or a combination of nonenzymatic and enzymatic (selenium and zinc), led to an increase in the TAC level and an improvement in the clinical condition, evidenced by a decrease in the time spent on mechanical ventilation and in the ICU, with faster discharge from the hospital but with no effect on the incidence of mechanical ventilation or the mortality rate.