Anesthesia & Clinical Research
Open Access

Abstract

Effects of the Antioxidant-Enriched Concentrated Liquid Diet ANOM on Oxidative Stress and Multiple Organ Injury in Patients with Septic Shock: A Pilot Study

Shigekiyo Matsumoto, Hironori Koga, Junya Kusaka, Satoshi Hagiwara, Keisuke Shihara, Shinya Kai, Chihiro Shingu, Taichi Nishida and Takayuki Noguchi

Purpose: In patients with septic shock, excessive production of reactive oxygen species (ROS) by activated neutrophils injures the vascular endothelium. The body responds by recruiting systemic antioxidants, among which vitamin C most rapidly responds. Excessive and prolonged ROS production quickly depletes vitamin C, which is not synthesized by the human body. To improve the prognosis of patients with septic shock, we evaluated the ability of an antioxidant-enriched liquid diet to alleviate oxidative stress and multiple organ failure.

Methods: We evaluated 15 patients with septic shock complicated by multiple organ failure who underwent treatment with ANOM® (antioxidant-enriched concentrated liquid diet, Otsuka Pharmaceutical Co, Tokushima, Japan). Vitamin C concentration was determined by measuring serum levels of vitamin C radicals (VCR) with electron spin resonance (ESR) spectroscopy.

Results: Serum VCR concentration was significantly increased from the baseline level of 0.155±0.026 after 1 day of ANOM infusion, reaching the normal range at day 3, and 0.642±0.059 at day 7. Serum 8-hydroxydeoxyguanosine (8-OHdG) concentration, a measure of ROS-induced oxidative injury, was 0.495±0.061 ng/mL at day 7, which was significantly lower than the baseline level of 0.896±0.065 ng/mL. The Sepsis-related Organ Failure Assessment (SOFA) score, a measure of multiple organ failure, decreased significantly from 10.9±1.9 at baseline to 6.2±1.7 at day 7.

Conclusions: These findings show that ANOM rapidly restores vitamin C levels, suggesting that it protects against excessive oxidative stress and alleviates multiple organ failure in patients with septic shock.