Effects of Vitamin C on Organ Function in Cardiac Surgery Patients: A Systematic Review and Meta-Analysis
| Autor: | Sebastian Wendt, Ádám G. Majoros, Neill K. J. Adhikari, Christian Stoppe, Kai C. Clasen, Daren K. Heyland, Aileen Hill, Carina Benstoem |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Vitamin
medicine.medical_specialty antioxidant lcsh:TX341-641 030204 cardiovascular system & hematology Article law.invention 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine systematic review law Internal medicine medicine oxidative stress 030212 general & internal medicine ddc:610 Adverse effect Stroke Nutrition and Dietetics business.industry Organ dysfunction vitamin organ dysfunction Perioperative Ascorbic acid medicine.disease reperfusion injury Intensive care unit Cardiac surgery meta-analysis chemistry ascorbic acid medicine.symptom business lcsh:Nutrition. Foods and food supply cardiac surgery Food Science |
| Zdroj: | Nutrients Nutrients 11(9), 2103 (2019). doi:10.3390/nu11092103 special issue: "Special Issue "Vitamin C in the Critically Ill, Effects on Oxidative Stress and the Immune System" / Special Issue Editors: Prof. Heleen M Oudemans-van Straaten, Department of Intensive Care, VU University Medical Center, Amsterdam, Netherlands ; Dr. Angelique M.E. Spoelstra-de Man, Department of Intensive Care, VU University Medical Center, Amsterdam, Netherlands" Volume 11 Issue 9 Nutrients, Vol 11, Iss 9, p 2103 (2019) |
| ISSN: | 2072-6643 |
| Popis: | Background: Cardiac surgery is associated with oxidative stress and systemic inflammation, which both contribute to postoperative organ dysfunction. Vitamin C is a pleiotropic, antioxidant, and potentially organ-protective micronutrient. Past clinical trials and meta-analyses have focused predominantly on occurrence of postoperative atrial fibrillation. Therefore, we investigated the influence of perioperative vitamin C administration on clinically relevant parameters closer related to the patient&rsquo s recovery, especially organ function, and overall outcomes after cardiac surgery. Methods: Randomized controlled trials (RCTs) comparing perioperative vitamin C administration versus placebo or standard of care in adult patients undergoing cardiac surgery were identified through systematic searches in Pubmed, EMBASE, and CENTRAL on 23 November 2018. Published and unpublished data were included. Assessed outcomes include organ function after cardiac surgery, adverse events, in-hospital mortality, intensive care unit, and hospital length-of-stay. Data was pooled only when appropriate. Results: A total of 19 RCTs with 2008 patients were included in this meta-analysis. Vitamin C significantly decreased the incidence of atrial fibrillation (p = 0.008), ventilation time (p < 0.00001), ICU length-of-stay (p = 0.004), and hospital length-of-stay (p < 0.0001). However, on average, vitamin C had no significant effects on in-hospital mortality (p = 0.76), or on the incidence of stroke (p = 0.82). High statistical heterogeneity was observed in most analyses. Conclusions: Vitamin C impacts clinically and economically important outcomes, such as ICU and hospital length-of-stay, duration of mechanical ventilation and lowers the incidence of atrial fibrillation. Due to missing reports on organ dysfunction, this meta-analysis cannot answer the question, if vitamin C can improve single- or multiorgan function after cardiac surgery. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|