Antioxidants like vitamin C can make the difference between life and death in critically injured patients, according to a new study from Vanderbilt University Medical Center in Nashville. The study showed that antioxidants can heavily influence whether patients suffer potentially lethal multiple organ failure after surgery for traumatic injuries. In spite of modern surgical techniques and the use of the latest antibiotics, many trauma victims who survive their injury frequently die of multiple-organ failure following surgery. According to study leader Bryan Cotton, MD, such deaths are often the result of “oxidative stress,” which is the result of the release into the body of oxygenated molecules known as free radicals.
Dr. Cotton said previous research has shown that in critically injured patents the store of antioxidants, which serve to neutralize free radicals, is quickly depleted. While antibiotics are essential following surgery, they are by themselves not enough, according to the study. Antioxidant therapy, in the form of vitamins C and E and the mineral selenium, can quickly replenish the body’s stores and help overcome fatal infections.
“Antioxidant therapy is so simple and that’s what throws people off,” Dr. Cotton said, who became interested in it after seeing results of a trial that showed inflammation in patients who received antioxidants was greatly improved over patients who did not. “When we learned it would cost only $11 a patient for a seven-day course of antioxidants, we decided to give it a try.”
The study tracked over 4,000 patients admitted to the Vanderbilt University Medical Center trauma unit. High-dose antioxidants were administered to all injured patients (about 2,200 patients in total) between October 1, 2005, and September 30, 2006. Treatment included 1,000 mg. of vitamin C and 1,000 IU of vitamin E every eight hours by mouth, and 200 mcg. of selenium once a day intravenously. Results of the treatment were compared to about 2,000 patients admitted between October 1, 2005 and September 20, 2005, which was in the time period before antioxidant treatment was initiated. In the patients who received the antioxidant treatment, abdominal compartment syndrome occurrences were reduced from 90 to 31, catheter-related infections were reduced from 75 to 50, surgical site infections from 101 to 44 or a 53% decrease with antioxidant protection, and pulmonary failure reduced from 721 to 528 or a 48% decreased risk of respiratory failure between patients given antioxidants vs. those without.
The study team is now trying to determine optimal dosages. Dr. Cotton said, “While we are all looking for that magic bullet to cure some of the horrible things that can happen after someone is injured or has an operation, we have something at our disposal. It might not be that magic bullet, but it is a very inexpensive and safe way to reduce complications and mortality in the sickest patients.” The study is published in theJournal of the American College of Surgeons2008; 207: S40-S41.
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