Skip to main content
SpringerLink
Log in

Serum alpha-tocopherol levels after high-dose enteral vitamin E administration in patients with acute respiratory failure

  • Original Articles
  • Published:
Intensive Care Medicine Aims and scope Submit manuscript

Abstract

Serum levels of tocopherols were measured in 5 healthy volunteers and in 14 patients with acute respiratory failure before and after onset of high-dose enteral vitamin E administration. The initial alphatocopherol levels did not differ between both groups (12.1±2.7 μg/ml in the volunteers and 11.3±3.5 μg/ml in the patient; mean±SD). After oral administration of 1 g d,l-alpha-tocopherylacetate per day the serum levels more than doubled within 1 day and reached a plateau between 22 and 30 μg/ml after 3 days in the volunteers. In contrast, application of even 3 g vitamin E/day by gastric tube in the patients with respiratory failure caused only a delayed increase of the serum levels with values nearly doubling after 5–10 days (6 patients), or there was no increase at all (8 patients). Serum alpha-tocopherol did not rise in patients without accompanying highmolecular weight formula diet and in patients with prolonged hemodynamic insufficiency and metabolic acidosis. The age of the patients, the fact of severe blood losses, hemodialysis and hemofiltration and the final out-come of death or survival appeared to be without influence on the response to enteral vitamin application. Neither in the volunteers nor in the patients with acute respiratory failure were there any detectable amounts of beta-, gamma- or delta-tocopherol or of alphatocopherolquinone or alpha-tocotrienol.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Bayfield RF, Romalis LF (1979) An improved method for the determination of alpha-tocopherol in sheep liver. Anal Biochem 97:264

    Google Scholar 

  2. Bell EF, Brown EJ, Milner R (1979) Vitamin E absorption in small premature infants. Pediatrics 63:830

    Google Scholar 

  3. Bertrand Y, Artoisenet A, Allard B, Barbier B, de Meulder A, Raynaert M, Mathieu P, Dumont E (1985) Lipid peroxidation and alpha-tocopherol during an acute respiratory failure after near drowning. Intensive Care Med 11:65

    Google Scholar 

  4. Bieri JG, Corash L, Hubbard VS (1983) Medical uses of vitamin E. N Engl J Med 308:1063

    Google Scholar 

  5. Chiarotti M, Giusti GV (1978) Determination of submicrogram levels in alpha-tocopherol in serum by gas-liquid chromatography with solid injections. J Chromatogr 147:481

    Google Scholar 

  6. Chiswick ML, Johnson M, Woodhall C, Gowland M, Davies J, Toner M, Sims DG (1983) Protective effect of vitamin E against intraventricular hemorrhage in premature babies. Br Med J 287:81

    Google Scholar 

  7. Deneke SM, Fanburg BL (1980) Normobaric oxygen toxicity of the lung. N Engl J Med 303:76

    Google Scholar 

  8. Ehrenkranz RA, Ablow RC, Warshaw JB (1982) Effect of vitamin E on the development of oxygen induced lung injury in neonates. Adv NY Acad Sci 393:452

    Google Scholar 

  9. Elsayed NM (1982) Dietary antioxidants and the biochemical response to oxidant inhalation. 1 Influence of dietary vitamin E on the biochemical effects of nitrogen dioxide exposure in the rat lung. Toxicol Appl Pharmacol 66:319

    Google Scholar 

  10. Farrel PM, Willison JW (1975) Megavitamin E supplementation in man. Fed Proc 34:912

    Google Scholar 

  11. Hittner HM, Godio LB, Rudolph AJ, Adams JM, Garcia-Prats JA, Friedman Z, Kautz JA, Monaco WA (1981) Retrolental fibroplasia: efficacy of vitamin E in a double blind clinical study of preterm infants. N Engl J Med 305:1365

    Google Scholar 

  12. Jansson L, Nilsson B, Lindgren R (1980) Quantitation of serum tocopherols by high-performance liquid chromatography with fluorescence detection. J Chromatogr 181:242

    Google Scholar 

  13. Jansson L, Lindroth M, Tyoeppoenen J (1984) Intestinal absorption of vitamin E in low birth weight infants. Acta Padiatr Scand 73:329

    Google Scholar 

  14. Kayden HJ (1978) The transport and distribution of alphatocopherol in serum lipoproteins and the formed elements of the blood. In: de Duve C, Hayaishi O (eds) Tocopherol, oxygen and biomembranes. Elsevier/North Holland, Amsterdam New York, p 131

    Google Scholar 

  15. Kovats E (1958) Gaschromatographische Charakterisierung organischer Verbindungen. Teil I: Retentionsindices aliphatischer Halogene, Alkohole, Aldehyde und Ketone. Helv Chim Acta 41:915

    Google Scholar 

  16. Leenheer AP, de Bevere VO, Cruyl AA, Clays AE (1978) Determination of serum alpha-tocopherol (vitamin E) by high performance liquid chromatography. Clin Chem 24:585

    Google Scholar 

  17. Lorch V, Murphy MD, Hoersten LR, Harris E, Fitzgerald J, Sinha SN (1985) Unusual syndrome among premature infants: association with a new intravenous vitamin E product. Pediatrics 75:598

    Google Scholar 

  18. Lovelady HG (1973) Separation of individual tocopherols from human plasma and red blood cells by thin-layer and gas liquid chromatography. J chromatogr 85:81

    Google Scholar 

  19. Machlin LJ, Gabriel E (1982) Kinetics of tissue alphatocopherol uptake and depletion following administration of high levels of vitamin E. Adv NY Acad Sci 393:48

    Google Scholar 

  20. Mathias PM, Harries JT, Peters TJ, Muller DPR (1981) Studies on the in vivo absorption of micellar solutions of tocopherol and tocopherylacetate in the rat. J Lipid Res 22:829

    Google Scholar 

  21. McCay PM, King MM, Poyer LJ, Lai EK (1982) An update of antioxidant theory: spin trapping of trichloromethyl radicals in vivo. Adv NY Acad Sci 393:23

    Google Scholar 

  22. Muller DPR, Lloyd JK (1982) Effect of large oral doses of vitamin E on the neurological sequelae of patients with abetalipoproteinemia. Adv NY Acad Sci 393:133

    Google Scholar 

  23. National Heart, Lung and Blood Institute USA (1979) Extracorporeal support for respiratory insufficiency (ECMO Study)

  24. Northway WH (1978) Bronchopulmonary dysplasia and vitamin E. N Engl J Med 299:599

    Google Scholar 

  25. Österlöf G, Nyheim A (1980) The estimation of alphatocopherol in biological material by gas chromatography. J Chromatogr 183:487

    Google Scholar 

  26. Pratt IS, Keeling PL, Smith LL (1980) The effect of high concentrations of oxygen on paraquat and diquat toxicity in rats. Arch Toxicol [Suppl] 4:415

    Google Scholar 

  27. Rao GHR, Crick TP, White JG (1980) Preparation separation and characterization of vitamin E quinone. J Chromatogr 196:506

    Google Scholar 

  28. Rinaldo JE, Rogers RM (1982) Adult respiratory distress syndrome: changing concepts of lung injury and repair. N Engl J Med 306:900

    Google Scholar 

  29. Seeger W, Wolf H, Stähler G, Neuhof H, Roka L (1982) Influence of tocopherol, its chromane compound, phytyl chains and superoxide dismutase on increased pulmonary vascular resistance and permeability due to arachidonate metabolism in isolated rabbit lungs. Prostaglandins 23:175

    Google Scholar 

  30. Seeger W (1984) Arachidonsäure-Kaskade und pulmonale Mikrozirkulation. Modell der initialen Phase des ARDS. Med Welt 35:1463

    Google Scholar 

  31. Seeger W, Suttorp N (1987) Role of membrane lipids in the pulmonary vascular abnormalities caused by bacterial toxins. Am Rev Respir Dis (in press)

  32. Shahar E (1980) Paraquat poisoning in a child: vitamin E in amelioration of lung injury. Arch Dis Child 55:830

    Google Scholar 

  33. Suttorp N (1984) Reaktive Sauerstoffmetabolite und pulmonale Sauerstofftoxizität. Med Welt 35:1513

    Google Scholar 

  34. Takeda K, Shimada Y, Amano M, Sakai T, Okada T, Yoshida I (1984) Plasma lipid peroxides and alpha-tocopherol in critically ill patients. Crit Care Med 12:957

    Google Scholar 

  35. Tripathi BJ, Tripathi RC (1984) Cellular and subcellular events in retinopathy of oxygen toxicity with a preliminary report of the preventive role of vitamin E and gamma-aminobutyric acid: a study in vitro. Curr Eye Res 3:193

    Google Scholar 

  36. Ward JA, Roberts RJ (1984) Vitamin E inhibition of the effect of hyperoxia on the pulmonary surfactant system of the newborn rabbit. Pediatr Res 18:329

    Google Scholar 

  37. Widhalm K, Hölzl M, Brubacher G (1985) Lipids, lipoproteins and alpha-tocopherol: relationship and changes during adolescence. Ann Nutr Metab 29:12

    Google Scholar 

  38. Witting LA (1980) Vitamin E and lipid antioxidants in freeradical-initiated reactions. In: Pryor WA (ed) Free radicals in biology IV. Academic Press, New York, p 295

    Google Scholar 

  39. Wolf H, Seeger W (1982) Experimental and clinical results in shock lung treatment with vitamin E. Adv NY Acad Sci 393:392

    Google Scholar 

  40. Yoshikawa T, Furukawa Y, Murakami M, Watanabe K, Kondo M (1982) Effect of vitamin E on endotoxin-induced disseminated intravascular coagulation in rats. Thromb Haemost 48:235

    Google Scholar 

Download references

Author information

Author notes

  1. H. R. D. Wolf

    Present address: Diakonissenkrankenhaus, Diakonissenstraße 28, D-7500 Karlsruhe, Rüppur, FRG

Authors and Affiliations

  1. Medizinische Klinik, Department of Internal Medicine, Justus-Liebig-Universität Gießen, Gießen, FRG

    W. Seeger, A. Ziegler & H. R. D. Wolf

Authors
  1. W. Seeger
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Ziegler
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. H. R. D. Wolf
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

This manuscript includes parts of the thesis of A. Ziegler

Rights and permissions

Reprints and permissions

About this article

Cite this article

Seeger, W., Ziegler, A. & Wolf, H.R.D. Serum alpha-tocopherol levels after high-dose enteral vitamin E administration in patients with acute respiratory failure. Intensive Care Med 13, 395–400 (1987). https://doi.org/10.1007/BF00257683

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00257683

Key words

Search

Navigation