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

Aileen Hill, Sebastian Wendt, Carina Benstoem, Christina Neubauer, Patrick Meybohm, Pascal Langlois, Neill Kj Adhikari, Daren K Heyland, Christian Stoppe, Aileen Hill, Sebastian Wendt, Carina Benstoem, Christina Neubauer, Patrick Meybohm, Pascal Langlois, Neill Kj Adhikari, Daren K Heyland, Christian Stoppe

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.

Conflict of interest statement

The authors declare no conflict of interest that may be perceived as inappropriately influencing the representation or interpretation of reported research results.

Figures

Figure 1
Figure 1
Pathophysiological mechanisms of organ damage in cardiac surgery.
Figure 2
Figure 2
Cerebral dysfunction after cardiac surgery.
Figure 3
Figure 3
Cardiovascular dysfunction after cardiac surgery, LCOS = low cardiac output syndrome.
Figure 4
Figure 4
Pulmonary dysfunction after cardiac surgery.
Figure 5
Figure 5
Renal dysfunction in cardiac surgery.
Figure 6
Figure 6
Gastrointestinal dysfunction after cardiac surgery.
Figure 7
Figure 7
Coagulation disorders after cardiac surgery.
Figure 8
Figure 8
Dysfunction of the immune system after cardiac surgery.

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Source: PubMed

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