1. Introduction
inflammation, MOF, organ dysfunction, septic shock, sepsis
MULTIPLE ORGAN FAILURE, PCT, INFLAMMATION, MOF, DYSFUNCTION, SEPTIC SHOCK, SEPSIS
These authors share first authorship.Background and aim: Here, we assess the effect of adjuvant antioxidant therapies in septic shock patients with organ dysfunction and their effect on the enzymatic and non-enzymatic antioxidant systems. Methods: Randomized clinical trial run between 2018 and 2022. One hundred and thirty-one patients with septic shock were included in five groups with 25, 27, 24, 26 and 29 patients each. Group 1 received vitamin C (Vit C), Group 2 vitamin E (Vit E), Group 3 n-acetylcysteine (NAC), Group 4 melatonin (MT) and group 5 no treatment. All antioxidants were administered orally or through a nasogastric tube for 5 days as an adjuvant to standard therapy. Results: All patients had multiple organ failure (MOF) and low Vit C levels. Vit C therapy decreased CRP, PCT and NOSepsis and septic shock cause a high mortality in Intensive Care Units (ICU) throughout the world and 80% of patients with this condition are admitted with multiple organ failure (MOF) [These conditions generate high costs to the public health system worldwide and to the families of the patients. Therefore, different strategies have been evaluated to predict the prognosis and reduce costs [However, there are other mechanisms involved during sepsis including deregulation of hemodynamic and oxidative stresses (OS), which exert a synergistic effect with inflammation and lead to dysfunction in various organs. Therefore, the use of antioxidants is currently being investigated [The systemic response that triggers sepsis leads to dysfunction in the heart through compensatory reaction of the sympathetic nervous system, leading to micro vascular dysfunction with activation of the immune system. The activation of the immune system damages tissues through a cascade that involves damage-associated molecular patterns, pathogen-associated molecular patterns [On the other hand, antioxidant therapy in septic shock has been proposed since Hippocrates, who used myrrh (Therefore, the aim of this study was to evaluate the use of antioxidants concomitantly with standard therapy in patients with septic shock with MOF, through a randomized clinical trial (RCT). We also evaluate the effect on various biomarkers of the enzymatic and non-enzymatic antioxidant system, before and after therapeutic intervention.