Patients are enrolled after acquisition of the informed consent approved by a Severance hospital institutional review board (Approval No. of IRB: 4-2012-0188). Blood sample is drawn at 1st day, 3rd day, and 7th day after admitting to intensive care unit (ICU) regardless of the disposition of the patients after discharge from the ICU. The primary endpoint of this study is to evaluate the correlation of the level of oxygen radical activity and severity of the patients. And secondary endpoints are (1) correlation of the level of oxygen radical activity and outcome, i.e., LOS in ICU and

hospital, 30 day mortality, in-hospital mortality; (2) correlation of the level Adriamycin clinical trial of antioxidant and severity and outcome of the patients; (3) relationship of Selleck PU-H71 the level of the oxygen radical activity and antioxidants. Data collection Investigators have collected the data including the followings: (1) patient characteristics, i.e., demographic data, severity of sepsis (severe sepsis or septic shock), presence of shock; (2) severity score

for 7 days in ICU, i.e., APACHE II score, SOFA score, MODS; (3) clinical progress, i.e., vital signs, daily VX-680 concentration intake and output; (4) clinical outcomes, i.e., duration of shock, use of mechanical ventilation (MV), duration of MV, length of stay(LOS) in ICU, LOS in hospital, 30 day mortality, in-hospital mortality, complications. Blood samples are drawn to check the level of oxygen radical activity, antioxidation activity, level of the antioxidant (zinc, selenium, check and glutamate) (Table 1). Table 1 Collection of dataset of the enrolled patients Day of ICU*admission APACHE II**score Severity scoring (MODS†, SOFA‡) Clinical courses (Vasopressors, Shock,

MV§, Complications) Oxygen radical activity and antioxidation activity Antioxidants (Zn∥, Se¶, Glutamate) 1st day O O O O O 2nd day     O     3rd day   O O O O 4th day     O     5th day     O     6th day     O     7th day   O O O O * ICU intensive care unit, ** APACHE II acute physiology and chronic health evaluation II, † MODS multi-organ dysfunction score, ‡ SOFA sequential organ failure assessment, § MV mechanical ventilation, ∥ Zn zinc, ¶ Se selenium. Oxygen radical activity and antioxidation activity are assessed using CR3000® (Callegari 1930, Italy). Free oxygen radicals test (FORT) kit check the serum H2O2 level directly as oxygen radical. Free oxygen radicals detection (FORD) kit assess the antioxidation activity that check the reactivity with vitamic C, Trolox, albumin, and glutathione to free radical – chromogen. The levels of the zinc, selenium and glutamate are assessed in the laboratory. Statistical analysis The results will be expressed as standard statistical metrics: median (range), mean ± standard deviation for continuous variables. The primary endpoint of this study is to evaluate the correlation of the level of oxygen radical activity and severity of the patients.