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

Nutrients. 2018 Jul 27;10(8):974. doi: 10.3390/nu10080974.

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.

Publication types

  • Review

MeSH terms

  • Antioxidants / therapeutic use*
  • Ascorbic Acid / therapeutic use*
  • Cardiac Surgical Procedures / adverse effects*
  • Cardiovascular System / physiopathology
  • Critical Care
  • Humans
  • Kidney / physiopathology
  • Multiple Organ Failure / prevention & control*
  • Nervous System / physiopathology
  • Oxidative Stress
  • Postoperative Complications / prevention & control*
  • Vitamins / therapeutic use*

Substances

  • Antioxidants
  • Vitamins
  • Ascorbic Acid