{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:35:16Z","timestamp":1788309316655,"version":"build-2803163510"},"reference-count":85,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2023,5,6]],"date-time":"2023-05-06T00:00:00Z","timestamp":1683331200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Institute National of Cardiology"},{"name":"Ignacio Ch\u00e1vez."},{"name":"Centro Medico ABC Observatory"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cells"],"abstract":"<jats:p>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 NO3\u2212\/NO2\u2013 but increased Vit C levels. The SOFA score decreased with MT in 75%, Vit C 63% and NAC 50% vs. controls 33% (p = 0.0001, p = 0.03 and p = 0.001 respectively). MT diminished lipid peroxidation (LPO) (p = 0.01) and improved total antioxidant capacity (TAC) (p = 0.04). Vit E increased thiol levels (p = 0.02) and tended to decrease LPO (p = 0.06). Selenium levels were decreased in the control group (p = 0.04). Conclusions: Antioxidants used as an adjuvant therapy in the standard treatment of septic shock decrease MOF and oxidative stress markers. They increase the TAC and thiols, and maintain selenium levels.<\/jats:p>","DOI":"10.3390\/cells12091330","type":"journal-article","created":{"date-parts":[[2023,5,8]],"date-time":"2023-05-08T01:32:53Z","timestamp":1683509573000},"page":"1330","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Randomized Clinical Trial of Antioxidant Therapy Patients with Septic Shock and Organ Dysfunction in the ICU: SOFA Score Reduction by Improvement of the Enzymatic and Non-Enzymatic Antioxidant System"],"prefix":"10.3390","volume":"12","author":[{"given":"Alfredo","family":"Aisa-\u00c1lvarez","sequence":"first","affiliation":[{"name":"Critical Care Department, American British Cowdray (ABC) Medical Center, I.A.P. ABC Sur 136 No. 116 Col. Las Am\u00e9ricas, M\u00e9xico City 01120, Mexico"},{"name":"UNAM Master\u2019s and Doctoral Program in Medical, Dental and Health Sciences UNAM, M\u00e9xico. Av. Universidad 3000, Coyoac\u00e1n, M\u00e9xico City 04510, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Israel","family":"P\u00e9rez-Torres","sequence":"additional","affiliation":[{"name":"Cardiovascular Biomedicine Department, Instituto Nacional de Cardiolog\u00eda Ignacio Ch\u00e1vez, Juan Badiano 1, Secci\u00f3n XVI, Tlalpan, M\u00e9xico City 14080, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2655-7590","authenticated-orcid":false,"given":"Ver\u00f3nica","family":"Guarner-Lans","sequence":"additional","affiliation":[{"name":"Physiology Department, Instituto Nacional de Cardiolog\u00eda Ignacio Ch\u00e1vez, Juan Badiano 1, Secci\u00f3n XVI, Tlalpan, M\u00e9xico City 14080, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linaloe","family":"Manzano-Pech","sequence":"additional","affiliation":[{"name":"Cardiovascular Biomedicine Department, Instituto Nacional de Cardiolog\u00eda Ignacio Ch\u00e1vez, Juan Badiano 1, Secci\u00f3n XVI, Tlalpan, M\u00e9xico City 14080, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randall","family":"Cruz-Soto","sequence":"additional","affiliation":[{"name":"Immunology Department, Instituto Nacional de Cardiolog\u00eda Ignacio Ch\u00e1vez, Juan Badiano 1, Secci\u00f3n XVI, Tlalpan, M\u00e9xico City 14080, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo","family":"M\u00e1rquez-Velasco","sequence":"additional","affiliation":[{"name":"Immunology Department, Instituto Nacional de Cardiolog\u00eda Ignacio Ch\u00e1vez, Juan Badiano 1, Secci\u00f3n XVI, Tlalpan, M\u00e9xico City 14080, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio","family":"Casarez-Alvarado","sequence":"additional","affiliation":[{"name":"Immunology Department, Instituto Nacional de Cardiolog\u00eda Ignacio Ch\u00e1vez, Juan Badiano 1, Secci\u00f3n XVI, Tlalpan, M\u00e9xico City 14080, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juvenal","family":"Franco-Granillo","sequence":"additional","affiliation":[{"name":"Critical Care Department, American British Cowdray (ABC) Medical Center, I.A.P. ABC Sur 136 No. 116 Col. Las Am\u00e9ricas, M\u00e9xico City 01120, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcela Elizabeth","family":"N\u00fa\u00f1ez-Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Central Laboratory Department, ABC Hospital Observatory, Sur 136 No. 116 Col. Las Am\u00e9ricas, M\u00e9xico City 01120, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Elena","family":"Soto","sequence":"additional","affiliation":[{"name":"Immunology Department, Instituto Nacional de Cardiolog\u00eda Ignacio Ch\u00e1vez, Juan Badiano 1, Secci\u00f3n XVI, Tlalpan, M\u00e9xico City 14080, Mexico"},{"name":"Department of the Cardiovascular, Division of the American British Cowdray Medical Center, Sur 136 No. 116 Col. Las Am\u00e9ricas, M\u00e9xico City 01120, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,5,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1708","DOI":"10.1097\/01.CCM.0000174478.70338.03","article-title":"Outcome Measures for Clinical Research in Sepsis: A Report of the 2nd Cambridge Colloquium of the International Sepsis Forum","volume":"33","author":"Marshall","year":"2005","journal-title":"Crit. Care Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1303","DOI":"10.1097\/00003246-200107000-00002","article-title":"Epidemiology of Severe Sepsis in the United States: Analysis of Incidence, Outcome, and Associated Costs of Care","volume":"29","author":"Angus","year":"2001","journal-title":"Crit. 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