• Wei-Erh Cheng, Chuen-Ming Shih, Liang-Wen Hang, Kuen-Yuh Wu, Hsin-Ling Yang, Wu-Huei Hsu, and Te-Chun Hsia.
• Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, 2 Yuh-Der Rd., 404 Taichung, Taiwan. derrick.hsia@msa.hinet.net
• Intensive Care Med. 2007 Aug 1; 33 (8): 1468-72.

ObjectiveTo determine whether urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG), an in vivo parameter of oxidative stress, is correlated with the outcome of critically septic patients.Design And SettingClinical outcome study in an adult medical ICU.PatientsEighty-five consecutive septic patients: 59 men and 26 women.Measurements And ResultsUrinary 8-OHdG was analyzed using isotope-dilution liquid chromatography with tandem mass spectrometry (LC/MS/MS). ICU mortality in these 85 septic patients was 25.9% (n = 22) and hospital mortality 38.8% (n = 33). APACHE II scores of survivors on day 1, on day 3, and the difference between them differed significantly from those of nonsurvivors (day 1, 21.0 +/- 7.1 vs. 25.9 +/-8.0; day 3, 15.0 +/- 5.8 vs. 23.2 +/- 8.3; difference, 6.0 +/- 5.5 vs. 1.7 +/- 6.6). Urinary 8-OHdG was significantly lower in survivors than in nonsurvivors on day 1 (1.8 +/- 2.4 vs. 3.0 +/- 2.4). The area under receiver operating characteristic curve analysis for the association between day 1 urinary 8-OHdG and ICU mortality was 0.71. The comparison performed upon discharge from hospital revealed similar results.ConclusionsThis is a preliminary study. The excretion of the urinary 8-OHdG, as measured using isotope-dilution LC/MS/MS, as the APACHE II score, were correlated with the outcome of critically septic patients in medical ICU.

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