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Vitamin C may shorten ventilation time in critically ill patients
The administration of vitamin C shortens the length of mechanical ventilation in critically ill patients, according to a review recently published in the Journal of Intensive Care.
Researchers have found that vitamin C administration shortened the duration of mechanical ventilation in critical care patients, although the effect depended on the severity of illness.
In five controlled trials including 471 patients requiring ventilation for over 10 hours, vitamin C shortened ventilation time on average by 25% according to a meta-analysis published in Journal of Intensive Care.
Vitamin C has numerous biochemical effects. It can influence the cardiovascular system through its involvement in the synthesis of norepinephrine and vasopressin, and energy metabolism through its participation in the synthesis of carnitine. In randomized trials, vitamin C has lowered blood pressure, decreased the incidence of atrial fibrillation and decreased bronchoconstriction. A previous meta-analysis of 12 controlled trials found that vitamin C reduced ICU stay on average by 8%.
Critical care patients often have very low vitamin C plasma levels. In healthy people, 0.1 grams per day of vitamin C is usually sufficient to maintain a normal plasma level. However, much higher doses, in the order of grams per day, are needed for critically ill patients to increase their plasma vitamin C levels to within the normal range. Therefore, high vitamin C doses may be needed to compensate for the increased metabolism in critically ill patients.
Harri Hemilä from the University of Helsinki, Finland, and Elizabeth Chalker from the University of Sydney, Australia, carried out a systematic review of vitamin C for mechanically ventilated critical care patients. They identified 9 relevant controlled trials, and 8 of them were included in the meta-analysis.
On average, vitamin C administration shortened ventilation time by 14%, but the effect of vitamin C depended on the duration of ventilation. Patients who are more seriously ill require longer ventilation than those who are not as sick. Therefore, Hemilä and Chalker hypothesized that the effect of vitamin C might be greater in trials with sicker patients who need longer ventilation.
Vitamin C had no effect when ventilation lasted for 10 hours or less. However, in 5 trials including 471 patients who required ventilation for over 10 hours, dosage of 1 to 6 g/day of vitamin C shortened ventilation time on average by 25%.
"Vitamin C is a safe, low-cost essential nutrient. Given the strong evidence of benefit for more severely ill critical care patients along with the evidence of very low vitamin C levels in such patients, ICU patients may benefit from the administration of vitamin C. Further studies are needed to determine optimal protocols for its administration. Future trials should directly compare different dosage levels," says Dr. Hemilä.
For more details click on the link: http://dx.doi.org/10.1186/s40560-020-0432-y
Hina Zahid Joined Medical Dialogue in 2017 with a passion to work as a Reporter. She coordinates with various national and international journals and association and covers all the stories related to Medical guidelines, Medical Journals, rare medical surgeries as well as all the updates in the medical field. Email:Â editorial@medicaldialogues.in. Contact no. 011-43720751
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751