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

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Department of Intensive Care Medicine, University Hospital RWTH, D-52074 Aachen, Germany
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Department of Anesthesiology, University Hospital RWTH, D-52074 Aachen, Germany
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3CARE—Cardiovascular Critical Care & Anesthesia Evaluation and Research, D-52074 Aachen, Germany
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Department of Thoracic, Cardiac and Vascular Surgery, University Hospital RWTH, D-52074 Aachen, Germany
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Department of Anesthesiology and Intensive Care, University Hospital Frankfurt, D-60590 Frankfurt, Germany
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Department of Anesthesiology and Reanimation, Faculty of Médecine and Health Sciences, Sherbrooke University Hospital, Sherbrooke, Québec, QC J1H 5N4, Canada
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Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Interdepartmental Division of Critical Care Medicine, University of Toronto; Toronto, ON M4N 3M5, Canada
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Clinical Evaluation Research Unit, Kingston General Hospital, Kingston, ON K7L 2V7, Canada
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Authors to whom correspondence should be addressed.
Nutrients 2018, 10(8), 974; https://doi.org/10.3390/nu10080974
Received: 26 June 2018 / Revised: 22 July 2018 / Accepted: 25 July 2018 / Published: 27 July 2018
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. View Full-Text
Keywords: vitamin C; ascorbic acid; cardiac surgery; antioxidant therapy; nutrient; oxidative stress; organ dysfunction; multi organ failure vitamin C; ascorbic acid; cardiac surgery; antioxidant therapy; nutrient; oxidative stress; organ dysfunction; multi organ failure
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Hill, A.; Wendt, S.; Benstoem, C.; Neubauer, C.; Meybohm, P.; Langlois, P.; Adhikari, N.K.; Heyland, D.K.; Stoppe, C. Vitamin C to Improve Organ Dysfunction in Cardiac Surgery Patients—Review and Pragmatic Approach. Nutrients 2018, 10, 974.

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