Role of Iron in Hyperoxia-Induced Lung Injury: One Step Forward in
Background: An increased oxidative stress in patients under treatment with high concentrations of oxygen (hyperoxia) is considered to be one of the major mechanisms of lung injury. Between different mediators, transition metal ions especially iron, by generation of very reactive free radicals play an important role in oxidative stress process. Disruption of normal iron hemostasis has been reported in hyperoxic conditions. So we hypothesized that chelation of iron can reduce hyperoxia- induced lung injury.
Methods: Mechanically ventilated patients, who received oxygen with FiO > 0.5 for at least 3 days, underwent bronchoscopy at baseline and 72 hours thereafter. Data from external control cases were collected prospectively to provide a comparative reference group.Iron and Iron-related proteins were measured in lavage fluid and plasma.
Results: In 24 patients and in comparison with the results of previous study, Iron concentration decreased significantly in lavage fluid (P<0.001). Reduction of ferritin was not significant in lavage fluid (P: 0.7).Transferrin decreased significantly in plasma (P: 0.01). Acute Physiology And Chronic Health Evaluation (APACHE) II (P: 0.006) score decreased significantly after 7 days of follow-up.
Conclusion: Deferasirox did not change Iron and Iron-related protein in hyperoxic condition and it just only could be considered along with other supportive measures for better toleration of oxygen therapy.
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