The impact of acute lung injury, ECMO and …

McDonald, C. I., et al. (2015). "The impact of acute lung injury, ECMO and transfusion on oxidative stress and plasma selenium levels in an ovine model." Journal of Trace Elements in Medicine and Biology 30: 4-10.

The purpose of this study was to determine the effects of smoke induced acute lung. injury (S-ALI), extracorporeal membrane oxygenation (ECMO) and transfusion on oxidative stress and plasma selenium levels. Forty ewes were divided into (i) healthy control (n = 4), (ii) S-ALI control (n = 7), (iii) ECMO control (n = 7), (iv) S-ALI + ECMO (n = 8) and (v) S-ALI + ECM + packed red blood cell (PRBC) transfusion (n = 14). Plasma thiobarbituric acid reactive substances (TBARS), selenium and glutathione peroxidase (GPx) activity were analysed at baseline, after smoke injury (or sham) and 0.25, 1, 2, 6, 7, 12 and 24 h after initiation of ECMO. Peak TBARS levels were similar across all groups. Plasma selenium decreased by 54% in S-ALI sheep (1.36 +/- 0.20 to 0.63 +/- 0.27 mu mol/L, p < 0.0001), and 72% in sheep with S-ALI + ECMO at 24 h (1.36 +/- 0.20 to 0.38 +/- 0.19, p < 0.0001). PRBC transfusion had no effect on TBARS, selenium levels or glutathione peroxidase activity in plasma. While ECMO independently increased TBARS in healthy sheep to levels which were similar to the S-ALI control, the addition of ECMO after S-ALI caused a negligible increase in TBARS. This suggests that the initial lung injury was the predominant feature in the TBARS response. In contrast, the addition of ECM in S-ALI sheep exacerbated reductions in plasma selenium beyond that of S-ALI or ECM alone. Clinical studies are needed to confirm the extent and duration of selenium loss associated with ECMO. Crown Copyright (C) 2015 Published by Elsevier GmbH. All rights reserved.