Defense mechanisms against lipid peroxidation were studied in erythrocytes from hypoxemic patients. The levels of lipid peroxides in patients erythrocytes were higher than those of control subjects (15.3 +/- 10.9 vs 7.5 +/- 3.0, p less than 0.05). The levels of reduced glutathione (GSH) decreased in erythrocytes from the patients (426 +/- 108 vs 756 +/- 201, p less than 0.01). Activities of glutathione peroxidase (GPX) and superoxide dismutase (SOD) were lower than those of control subjects (GPX; 27.6 +/- 7.1 vs 35.1 +/- 3.8, SOD; 76.6 +/- 42.9 vs 125.7 +/- 40.1, p less than 0.01). Positive correlations were observed between the levels of arterial oxygen pressures (PaO2) and the GSH concentrations, the activities of GPX and SOD, respectively. These data suggest that decreased anti-oxidant activity enhances lipid peroxidation in erythrocytes from hypoxemic patients.