Disorders of the oxidant-antioxidant system and energy metabolism indicators in children with adhesive intestinal obstruction depending on the severity of the adhesive process

Aim - to study the state of free radical processes, antioxidant potential, and the balance of energy metabolism indicators in children operated on for postoperative adhesive intestinal obstruction (AIO) depending on the severity of the adhesion process (AP). Materials and methods. The study was conducted in 49 children aged 7 to 17 years, operated on for postoperative AIO (the main group of patients). The control group consisted of 20 somatically healthy children of the same age. To study the state of lipid peroxidation (LP), the content of primary (diene conjugates (DC)) and secondary (thiobarbituric acid-active products (TBA-AP)) products of free radical processes in the blood serum were determined. To assess the state of antioxidant defense (AOD) in children, the activity of glutathione peroxidase (GP), glutathione transferase (GT) and glutathione reductase (GR), as well as the content of ceruloplasmin, were studied. To assess energy metabolism, we studied the content of ATP, lactate, pyruvate and lactate dehydrogenase (LDG). Results. It was found that the content of TBA-AP and DС in all sick children of the main group was increased compared to the indicators in healthy children. However, in severe AP, their level was significantly higher compared to the indicators in patients with mild AP. In all examined patients, depletion of AOD was established (significant decrease in the level of ceruloplasmin, GR, GT, GP). These changes were most pronounced in patients with severe AP. Also, significant disturbances in the content of energy metabolites were found in children with AIO (decrease in ATP and pyruvate levels, increase in lactate and LDG). A significant difference in the severity of these changes was established in children with mild and severe AP. Conclusions. In the postoperative period, children with AIO were found to have activation of free radical processes, decreased antioxidant potential, and imbalance of energy metabolism indicators. The most significant disorders were found in children with severe degree of AP. The research was carried out in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of the institution mentioned in the work. Informed consent of the patients was obtained for the research. No conflict of interest was declared by the authors.