Protection against stress-induced acute gastric mucosal injury by free radical scavengers

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Abstract
This study investigated whether the free radical scavengers allopurinol (50 mg p.o. q.i.d.) and dimethyl sulphoxide (DMSO, 500 mg p.o. q.i.d.) influence the incidence of stress-induced acute gastric mucosal injury in patients with pelvic fractures and hypovolaemic shock. In 177 fully evaluable patients (controln=58, allopurinoln=62, DMSOn=57), endoscopically proven stress-induced injury evolved in a significantly (p<0.01) larger number of controls relative to either group on active therapy. During the first 3 days after hospitalization, 13 controls (22%) developed the injury whereas only 2 patients in each of the allopurinol (3%) and DMSO (4%) groups had this injury. Of these cases, 8 controls (14%) and one patient in the allopurinol group (2%) deteriorated and underwent emergency surgery, however 3 of the controls (5%) died in the immediate post-operative period. The results suggest that oxygen-derived free radicals are directly implicated in stress-induced acute gastric mucosal injury and that removing them protects against this injury and its complications.