Reactive oxygen species as mediators of organ dysfunction caused by sepsis, acute respiratory distress syndrome, or hemorrhagic shock: potential benefits of resuscitation with Ringer's ethyl pyruvate solution

Curr Opin Clin Nutr Metab Care. 2002 Mar;5(2):167-74. doi: 10.1097/00075197-200203000-00009.


Reactive oxygen species are reactive, partly reduced derivatives of molecular oxygen. Important reactive oxygen species in biological systems include superoxide radical anion, hydrogen peroxide, and hydroxyl radical. Peroxynitrite, is another important species in biological systems. A variety of enzymatic and non-enzymatic processes can generate reactive oxygen species in mammalian cells. An extensive body of experimental evidence from studies using animal models supports the view that reactive oxygen species are important in the pathogenesis of ischemia-reperfusion syndromes, sepsis, acute respiratory distress syndrome, and multiple organ dysfunction syndrome. This view is further supported by data from clinical studies that correlate biochemical evidence of reactive oxygen species-mediated stress with the development of acute respiratory distress syndrome or sepsis in patients. Ethyl pyruvate, a simple derivative of pyruvic acid, has been shown to be efficacious in several animal models of critical illness, and warrants further evaluation in this regard.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Adult
  • Animals
  • Critical Care
  • Disease Models, Animal
  • Humans
  • Isotonic Solutions / pharmacology
  • Isotonic Solutions / therapeutic use*
  • Multiple Organ Failure / etiology
  • Multiple Organ Failure / physiopathology*
  • Multiple Organ Failure / therapy
  • NF-kappa B / physiology
  • Pyruvates / pharmacology
  • Pyruvates / therapeutic use
  • Reactive Oxygen Species / metabolism*
  • Respiratory Distress Syndrome / etiology
  • Respiratory Distress Syndrome / physiopathology*
  • Respiratory Distress Syndrome / therapy
  • Resuscitation
  • Sepsis / etiology
  • Sepsis / physiopathology*
  • Sepsis / therapy
  • Shock, Hemorrhagic / metabolism
  • Shock, Hemorrhagic / physiopathology*
  • Shock, Hemorrhagic / therapy


  • Isotonic Solutions
  • NF-kappa B
  • Pyruvates
  • Reactive Oxygen Species
  • Ringer's ethyl pyruvate
  • ethyl pyruvate