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. 2022 Apr 5;10(4):848.
doi: 10.3390/biomedicines10040848.

Urine Hydrogen Peroxide Levels and Their Relation to Outcome in Patients with Sepsis, Septic Shock, and Major Burn Injury

Miklos Lipcsey  1 , Maria Bergquist  2 , Rebecca Sirén  3 , Anders Larsson  4 , Fredrik Huss  5   6 , Jay Pravda  7 , Mia Furebring  8 , Jan Sjölin  8 , Helena Janols  8
Affiliations

Urine Hydrogen Peroxide Levels and Their Relation to Outcome in Patients with Sepsis, Septic Shock, and Major Burn Injury

Miklos Lipcsey et al. Biomedicines. .

Abstract

Hydrogen peroxide (H2O2) and oxidative stress have been suggested as possible instigators of both the systemic inflammatory response and the increased vascular permeability associated with sepsis and septic shock. We measured H2O2 concentrations in the urine of 82 patients with severe infections, such as sepsis, septic shock, and infections not fulfilling sepsis-3 criteria, in patients with major burn injury with associated systemic inflammation, and healthy subjects. The mean concentrations of H2O2 were found to be lower in patients with severe infections compared to burn injury patients and healthy subjects. Patients with acute kidney injury (AKI), vs. those without AKI, in all diagnostic groups displayed higher concentrations of urine H2O2 (p < 0.001). Likewise, urine concentrations of H2O2 were higher in non-survivors as compared to survivors (p < 0.001) at day 28 in all diagnostic groups, as well as in patients with severe infections and burn injury (p < 0.001 for both). In this cohort, increased H2O2 in urine is thus associated with mortality in patients with sepsis and septic shock as well as in patients with burn injury.

Keywords: AKI; H2O2; TBSA; burn injury; hydrogen peroxide; hypermetabolism; mortality; sepsis; shock.

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Conflict of interest statement

M.B. is employed by Astra Zeneca. The other authors declare that they have no competing interest.

Figures

Figure 1
Figure 1
Concentrations of urine H2O2 from admission (day 1) to day 5–6 in the ICU, stratified by sepsis (n = 37), septic shock (n = 23), infection (n = 4) and major burn injury (n = 18). H2O2 concentrations in urine from healthy subjects (n = 23) at one timepoint. ANOVA III for repeated measures was used to assess differences over time. Mean ± standard error of the mean (SEM). * p < 0.05, *** p < 0.001.
Figure 2
Figure 2
Concentrations of urine H2O2 from admission (day 1) to day 5–6 in the ICU, stratified by survivors (n = 71) and non-survivors (n = 11). ANOVA III for repeated measures was used to assess differences over time. Mean ± SEM. *** p < 0.001.
Figure 3
Figure 3
Concentrations of urine H2O2 from admission (day 1) to day 5–6 in the ICU, stratified by patients with acute kidney injury (AKI) (n = 12) and without AKI (n = 70). ANOVA III for repeated measures was used to assess differences over time. Mean ± SEM. *** p < 0.001.
Figure 4
Figure 4
Forest plot. Odds ratios for univariable logistic regression. Age has the unit of decades and H2O2 has the unit 10 µmol/L to optimize presentation in the figure. Odds ratio ± 95% confidence interval ( CI). * p < 0.05, ** p < 0.01.
See this image and copyright information in PMC

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