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Ascorbic acid dynamics in the seriously ill and injured
Abstract
Background In addition to the known beneficial effects of ascorbic acid on wound healing and the immune response, it is also a potent extracellular antioxidant. Recent work in septic rats suggests that high-dose ascorbic acid total parenteral nutrition (TPN) supplementation may protect cells from free radical injury and improve survival. In this study, we determined ascorbic acid levels in the immediate post-injury/illness period and evaluated the ability of early short-term high levels of ascorbic acid in TPN to normalize plasma levels.Materials and methods Ascorbic acid levels were determined in 12 critically injured patients and 2 patients with severe surgical infections. Each patient received TPN supplemented with increasing doses of ascorbic acid over a 6-day period. Therapeutic responses were determined by plasma and urine measurements using high-pressure liquid chromatography.Results The initial mean +/- SEM baseline plasma ascorbic acid concentration was depressed (0.11 +/- 0.03 mg/dl) and unresponsive following 2 days on 300 mg/day supplementation (0.14 +/- 0.03; P = 1.0) and only approached low normal plasma levels following 2 days on 1000 mg/day (0.32 +/- 0.08; P = 0.36). A significant increase was noted following 2 days on 3000 mg/day (1.2 +/- 0.03; P = 0.005).Conclusion We confirmed extremely low plasma levels of ascorbic acid following trauma and infection. Maximal early repletion of this vitamin requires rapid pool filling early in the post-injury period using supraphysiologic doses for 3 or more days.
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“Not surprisingly, surgery, trauma, sepsis, and burns are causing a decrease in blood vitamin C and, in very serious injuries, the drop can be very pronounced [172,173].”
From Vitamin C-Sources, Physiological Role, Kinetics, Deficiency, Use, Toxicity, and Determination (2021) · cites this paper as [173]
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Metadata
- Authors
- Long, C. L., Maull, K. I., Krishnan, R. S., Laws, H. L., Geiger, J. W., Borghesi, L., Franks, W., Lawson, T. C., & Sauberlich, H. E.
- Affiliations
- Carraway Methodist Medical Center (US)
- University of Alabama at Birmingham (US)
- Corresponding author
- Maull, K.I
- ORCID
- Long, C.L
- Venue
- Journal of Surgical Research
- Publisher
- Elsevier BV
- Published
- 2003-02
- Volume
- 109
- Issue
- 2
- Pages
- 144-148
- ISSN
- 0022-4804 (ISSN-L)
- OpenAlex
- W2136795074
- Cited by
- 254
- References
- 34
- Citations by year
- 2026: 5 · 2025: 10 · 2024: 10 · 2023: 15 · 2022: 20 · 2021: 25 · 2020: 24 · 2019: 25 · 2018: 19 · 2017: 6 · 2016: 10 · 2015: 4 · 2014: 12 · 2013: 13 · 2012: 4
- FWCI
- 3.43
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Surgical Research (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Vitamin C and Antioxidants Research
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Trauma, Hemostasis, Coagulopathy, Resuscitation
- Keywords
- vitamin C, total parenteral nutrition, critically injured patients, trauma (physical injury), sepsis, plasma ascorbic acid levels, vitamin C supplementation, antioxidants, wound healing, immune response, oxidative damage
- MeSH terms
- Adult, Antioxidants, Ascorbic Acid, Female, Humans, Male, Middle Aged, Parenteral Nutrition, Total, Time Factors, Wounds and Injuries, Critical Illness, Sepsis
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