Vitamin C requirement in surgical patients
Abstract
PURPOSE OF REVIEW: To summarize recent findings on vitamin C status and assess the requirement and optimal dose of supplementation in surgical patients. RECENT FINDINGS: Blood vitamin C concentration falls after uncomplicated surgery and further decreases in surgical intensive care unit patients. The decline may be owing to increased demand caused by increased oxidative stress. To normalize plasma vitamin C concentration, much higher doses than the recommended daily allowance or doses recommended in parenteral nutrition guidelines are needed in these patients. In uncomplicated surgical patients, more than 500 mg/day of vitamin C may be required, with much higher doses in surgical intensive care unit patients. In uncomplicated gastrointestinal surgery, continuous parenteral administration of 500 mg/day of vitamin C reduced postoperative oxidative stress as manifested by reduced urinary excretion of isoprostane. In some studies, postoperative atrial fibrillation was prevented after cardiac surgery by perioperative vitamin C supplementation. In critically ill patients, some prospective randomized controlled trials support parenteral supplementation of high doses of vitamin C, E and trace elements. SUMMARY: Vitamin C requirement is increased in surgical patients, and the potential advantage of supplementation is to increase the plasma and tissue levels of vitamin C and thereby reduce oxidative stress. Although some clinical benefits of high-dose vitamin C supplementation have been shown in the critically ill, the optimal dose for supplementation and the clinical benefits remain to be investigated in surgical patients.
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Surgery, trauma, sepsis, and burns cause a decrease in blood vitamin C, and in very serious injuries, the drop can be very pronounced.
“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 [172]
A single oral dose of vitamin C of 5-10 g produces transient osmotic diarrhea and/or abdominal bloating with pain but, otherwise, even such a high dose is considered to be safe.
“A single oral dose of vitamin C of 5–10 g produces transient osmotic diarrhea and/or abdominal bloating with pain but, otherwise, even such a high dose is considered to be safe.”
From Vitamin C-Sources, Physiological Role, Kinetics, Deficiency, Use, Toxicity, and Determination (2021) · cites this paper as [172]
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- Authors
- Fukushima, R., & Yamazaki, E.
- Affiliations
- Teikyo University (JP)
- Corresponding author
- Fukushima, Ryoji
- Venue
- Current Opinion in Clinical Nutrition and Metabolic Care
- Published
- 2010-11
- Volume
- 13
- Issue
- 6
- Pages
- 669-676
- ISSN
- 1363-1950 (ISSN-L)
- OpenAlex
- W2066857339
- Cited by
- 88
- References
- 50
- Citations by year
- 2026: 2 · 2025: 7 · 2024: 6 · 2023: 6 · 2022: 4 · 2021: 3 · 2020: 13 · 2019: 10 · 2018: 5 · 2017: 11 · 2016: 4 · 2015: 5 · 2014: 4 · 2013: 3 · 2012: 4
- FWCI
- 0.29
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Current Opinion in Clinical Nutrition & Metabolic Care (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Vitamin C and Antioxidants Research
- Health Sciences › Medicine › Biochemistry › Antioxidant Activity and Oxidative Stress
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Keywords
- vitamin C, vitamin C requirement, surgical patients, oxidative stress, isoprostanes, high-dose vitamin C, surgical intensive care unit, critically ill patients, postoperative atrial fibrillation, cardiac surgery, gastrointestinal surgery, plasma vitamin C concentration
- MeSH terms
- Ascorbic Acid, Ascorbic Acid Deficiency, Humans, Parenteral Nutrition, Postoperative Care, Postoperative Complications, Critical Illness, Oxidative Stress, Nutrition Policy, Dietary Supplements
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