Thiobarbituric acid reactive substances - TBARS - are formed as a byproduct of lipid peroxidation (i.e. as degradation products of fats) which can be detected by the TBARS assay using thiobarbituric acid as a reagent.
Because reactive oxygen species (ROS) have extremely short half-lives, they are difficult to measure directly. Instead, what can be measured are several products of the damage produced by oxidative stress, such as TBARS.
Assay of TBARS measures malondialdehyde (MDA) present in the sample, as well as malondialdehyde generated from lipid hydroperoxides by the hydrolytic conditions of the reaction. MDA is one of several low-molecular-weight end products formed via the decomposition of certain primary and secondary lipid peroxidation products. However, only certain lipid peroxidation products generate MDA, and MDA is neither the sole end product of fatty peroxide formation and decomposition, nor a substance generated exclusively through lipid peroxidation. These and other considerations from the extensive literature on MDA, TBA reactivity, and oxidative lipid degradation support the conclusion that MDA determination and the TBA test can offer, at best, a narrow and somewhat empirical window on the complex process of lipid peroxidation. Use of MDA analysis and/or the TBA test and interpretation of sample MDA content and TBA test response in studies of lipid peroxidation require caution, discretion, and (especially in biological systems) correlative data from other indices of fatty peroxide formation and decomposition.
Another method of determining oxidative stress is to measure the disappearance of antioxidants, such as alpha-tocopherol, from the blood. Because the majority of plasma tocopherols are found in plasma lipids, which have been shown to decrease in the critically ill, any measure of plasma tocopherols in the critically ill population should be indexed to total cholesterol.
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