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Nutrients. 2018 Jul 27;10(8). pii: E974. doi: 10.3390/nu10080974.

Vitamin C to Improve Organ Dysfunction in Cardiac Surgery Patients-Review and Pragmatic Approach.

Author information

1
Department of Intensive Care Medicine, University Hospital RWTH, D-52074 Aachen, Germany. ahill@ukaachen.de.
2
Department of Anesthesiology, University Hospital RWTH, D-52074 Aachen, Germany. ahill@ukaachen.de.
3
3CARE-Cardiovascular Critical Care & Anesthesia Evaluation and Research, D-52074 Aachen, Germany. ahill@ukaachen.de.
4
3CARE-Cardiovascular Critical Care & Anesthesia Evaluation and Research, D-52074 Aachen, Germany. swendt@ukaachen.de.
5
Department of Thoracic, Cardiac and Vascular Surgery, University Hospital RWTH, D-52074 Aachen, Germany. swendt@ukaachen.de.
6
Department of Intensive Care Medicine, University Hospital RWTH, D-52074 Aachen, Germany. cbenstoem@ukaachen.de.
7
3CARE-Cardiovascular Critical Care & Anesthesia Evaluation and Research, D-52074 Aachen, Germany. cbenstoem@ukaachen.de.
8
Department of Intensive Care Medicine, University Hospital RWTH, D-52074 Aachen, Germany. cneubauer@ukaachen.de.
9
3CARE-Cardiovascular Critical Care & Anesthesia Evaluation and Research, D-52074 Aachen, Germany. cneubauer@ukaachen.de.
10
Department of Anesthesiology and Intensive Care, University Hospital Frankfurt, D-60590 Frankfurt, Germany. patrick.meybohm@kgu.de.
11
Department of Anesthesiology and Reanimation, Faculty of Médecine and Health Sciences, Sherbrooke University Hospital, Sherbrooke, Québec, QC J1H 5N4, Canada. Pascal.laferriere-langlois@usherbrooke.ca.
12
Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Interdepartmental Division of Critical Care Medicine, University of Toronto; Toronto, ON M4N 3M5, Canada. neill.adhikari@sunnybrook.ca.
13
Clinical Evaluation Research Unit, Kingston General Hospital, Kingston, ON K7L 2V7, Canada. dkh2@queensu.ca.
14
Department of Intensive Care Medicine, University Hospital RWTH, D-52074 Aachen, Germany. christian.stoppe@gmail.com.
15
3CARE-Cardiovascular Critical Care & Anesthesia Evaluation and Research, D-52074 Aachen, Germany. christian.stoppe@gmail.com.

Abstract

The pleiotropic biochemical and antioxidant functions of vitamin C have sparked recent interest in its application in intensive care. Vitamin C protects important organ systems (cardiovascular, neurologic and renal systems) during inflammation and oxidative stress. It also influences coagulation and inflammation; its application might prevent organ damage. The current evidence of vitamin C's effect on pathophysiological reactions during various acute stress events (such as sepsis, shock, trauma, burn and ischemia-reperfusion injury) questions whether the application of vitamin C might be especially beneficial for cardiac surgery patients who are routinely exposed to ischemia/reperfusion and subsequent inflammation, systematically affecting different organ systems. This review covers current knowledge about the role of vitamin C in cardiac surgery patients with focus on its influence on organ dysfunctions. The relationships between vitamin C and clinical health outcomes are reviewed with special emphasis on its application in cardiac surgery. Additionally, this review pragmatically discusses evidence on the administration of vitamin C in every day clinical practice, tackling the issues of safety, monitoring, dosage, and appropriate application strategy.

KEYWORDS:

antioxidant therapy; ascorbic acid; cardiac surgery; multi organ failure; nutrient; organ dysfunction; oxidative stress; vitamin C

PMID:
30060468
PMCID:
PMC6115862
DOI:
10.3390/nu10080974
[Indexed for MEDLINE]
Free PMC Article

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