tailieunhanh - Báo cáo khoa học: "Serum uric acid, creatinine, and the assessment of antioxidant capacity in critical illness"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Serum uric acid, creatinine, and the assessment of antioxidant capacity in critical illness. | Available online http content 10 5 421 Letter Serum uric acid creatinine and the assessment of antioxidant capacity in critical illness Ivo Giovannini Carlo Chiarla Felice Giuliante Federico Pallavicini Maria Vellone Francesco Ardito and Gennaro Nuzzo Hepato-biliary Surgery Unit Sub-intensive Care and CNR-IASI Center for the Pathophysiology of Shock Catholic University School of Medicine Rome Italy Corresponding author Ivo Giovannini Published 4 September 2006 This article is online at http content 10 5 421 2006 BioMed Central Ltd Critical Care 2006 10 421 doi cc5008 See related research by Chuang et al. http content 10 1 R36 In their nice study on serum total antioxidant capacity TAC in sepsis 1 Chuang and coworkers have demonstrated an increase in TAC that was directly correlated to severity of illness and poor outcome and to increasing levels of serum uric acid UA . Although the increase in TAC might be interpreted as an extreme protective attempt against overwhelming inflammation this must still be proved as correctly commented on by the authors. A critical point is that although increasing UA enhances TAC the pathophysiological relevance depends on the underlying mechanism which may include detrimental factors such as renal dysfunction. In this case the obvious concern is the organ dysfunction causing UA to increase while the consequent increase in TAC should be considered coincidental. To ease this interpretation one should at least examine the relationship between UA or TAC and plasma creatinine concentration assuming that creatinine always accurately reflects renal function . Simply excluding patients with plasma creatinine mg dl or on hemodialysis 1 may not be sufficient to rule out an impact of moderate changes in renal function on UA. We are mentioning this because in an on-going study on changes in UA on more than 100 surgical patients with moderate to extreme illness we found