Study: Vitamin C supports recovery after heart surgery
Study: Vitamin C supports recovery after heart surgery
Reference
a. Sadeghpour, A. Alizadehasl, M. Kyavar et al. Effects of the vitamin C supplementation on the intensive care unit after Heart surgery and the hospital stay. Anesth Pain med. 2015; 5 (1): E25337.
Design
randomized, double -blind, placebo -controlled prospective study
participant
The intervention group consisted of 113 participants (80 men, 33 women). The placebo group had 177 participants (111 men, 66 women). Both groups were planned for various heart operations. The average age of the participants was 55.78 years + 13.72 years.
Intervention
vitamin C (as an ascorbic acid) or placebo: The intervention group received 2 g vitamin C intravenously immediately before the operation and 1 g for 4 days after the operation. The placebo ampoules and tablets were tailored to the vitamin C provided in shape and size.
target parameter
result parameters were selected that can influence the complications rates and/or recovery after heart surgery. These parameters included the time in the intensive care unit (ICU) after the operation, the total time in the hospital, the duration of intubation after the operation, the drainage volume in the intensive care unit and the first 24 hours after the operation and the incidence of atrial fibrillation after the operation.
important knowledge
While the time spent in the intensive care unit did not differ between the groups, the hospital stay varied significantly overall. The intervention group remained in the hospital for about 2 days less than the placebo group (17.10 + 4.63 d compared to 12 + 4.51 d; p = 0.01). The intervention group also had a shorter intubation period (11.83 + 3.91 h vs 14.14 + 9.52 p.m.; p = 0.003). The drainage volume in the intensive care unit was also less in the intervention group compared to placebo (499.55 cc + 296.69 cm³ compared to 577.96 cm³ + 454.44 ccm). The frequency of postoperative atrial fibrillation was 35.5 % in the vitamin C group compared to 55.9 % in the placebo group ( p = 0.001). Perhaps the most impressive was that there was a statistically significant difference in postoperative complications, defined as "death, every infection and any impairment of kidney function" ( p = 0.042).
Comment
This study is a simple example of inexpensive, natural intervention with profound effect on the results. The effect of a cumulative dose of 6 g vitamin C over 5 days appears remarkable. From a practical point of view, the low costs, the limited effort (4 tabs over 4 days) and the negligible disadvantage risk of using oral vitamin C should give a broad attractiveness.
This is not the first study to indicate that vitamin C can improve the results of heart surgery. Several studies have dealt with atrial fibrillation and found a benefit in moderate oral doses of vitamin C.
According to the current state of the evidence, vitamin C should be administered to all patients who undergo heart surgery, in particular a coronary artery bypass surgery.
In 2007, ESAMI and colleagues reported a dramatic improvement in taking 2 g oral in the night before the coronary bypass operation, then 1 g twice a day for 5 days after the operation. 1 Fifty patients were in the intervention group and 50 in the control group. All patients received beta blockers and wore Holter Monitors for 4 days after the procedure. The incidence of atrial fibrillation was 4 % in the ascorbic acid group and 26 % in the control group (ODDS ratio [or]: 0.119; 95 % confidence interval [CI]: 0.025-0.558; p = 0.002).
in 2014 showed a systematic review of 23 studies on supplementation with antioxidants and the results of heart surgery that a vitamin C supplementation was associated with a 50 percent reduction in the postoperative atrial lens (OR: 0.50; 95%-KI: 0.27–0.91; p = 0.02). 2 It was also associated with shorter hospital stays (average standard deviation: –0.325; 95 %-KI: –0.14; p <0.01). Apart from that, n-acetyl cysteine and polyunsaturated fatty acids, which both reduced the atrial fibrillation after the operation, albeit to a lesser extent as vitamin C, other antioxidant nutritional supplements that affect the results.
How exactly vitamin C improves the results is still being examined. In particular, atrial fibrillation seems to be a multifactorial process in which both oxidative stress and inflammatory reactants are involved. 3 The authors of the study reviewed here are most likely that this is most likely the mechanisms behind the postoperative benefit of vitamin C.
While a limited duration of the vitamin C supplement was used in the study examined, there may be good reasons to continue taking beyond the immediate postoperative hospital stay. For the extended postoperative period, the healing of the surgical wound should be considered. Ascorbic acid has been proven to increase collagen synthesis. 4.5 In the long term, vitamin C is an essential component of the health of the endothels, a topic that was previously treated by Daniel Chong, Nd, in the Special cardiological problem by magazine for naturopathy 6
A restriction of this study is that the status of the circulating vitamin C has not been measured. Whether there is an underlying vitamin C deficiency, which is corrected by a supplementation, or whether vitamin-C doses that are above the physiological saturation, cannot be followed. However, the overweight of the evidence in the systematic review of 23 studies mentioned above indicates that there is more than just a saturation in the workplace.
According to the current state of the evidence, vitamin C should be administered to all patients who undergo heart surgery, in particular a coronary artery bypass surgery. In view of simplicity and cost efficiency, it is a miracle that it is not yet part of the standard of treatment.
- eslami m, badkoubeh rs, mousavi m, et al. Oral ascorbic acid in combination with beta blockers is more effective than beta blockers solely in the prevention of atrial fibrillation after coronary artery bypass surgery. Texas Heart Inst J. 2007; 34 (3): 268-274.
- Ali-Hassan-Saygh S., Mirhosseini Sj., Rezaeisadrabadi M., et al. Antioxidant supplements to prevent atrial fibrillation after heart surgery: an updated comprehensive systematic review and meta-analysis of 23 randomized controlled studies. Interact Cardiovasc Thorac Surg. 2014; 18 (5): 646-654.
- Elahi mm, Flatman S, Matata BM. Persecution of the origins of the postoperative atrial fibrillation: the concept of oxidative stress-mediated myocardial injury phenomenon. EUR J Cardiovasc Prev Rehabil. 2008; 15 (6): 735-741.
- van Robertson WB, Schwartz B. Ascorbic acid and the formation of collagen. jbiolchem. 1953; 201 (2): 689-696.
- Tajima S, Pinnell Sr. Regulation of collagen synthesis through ascorbic acid. Ascorbic acid increases the Type i forecast mRNA. Biochem Biophys Res Commun. 1982; 106 (2): 632-637.
- chong D. The effect of vitamin C on the endothelial function. Nat med j. 2015; 7 (2S). http://natural medicinejournal.com/journal/2015-02/impact-vitamin-c-endothelial-function .