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Athanasiou A, Charalambous M, Anastasiou T, Aggeli K, Soteriades ES. Preoperative and postoperative administration of vitamin C in cardiac surgery patients - settings, dosages, duration, and clinical outcomes: a narrative review. Ann Med Surg (Lond) 2024; 86:3591-3607. [PMID: 38846824 PMCID: PMC11152825 DOI: 10.1097/ms9.0000000000002112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 04/16/2024] [Indexed: 06/09/2024] Open
Abstract
Vitamin C or ascorbic acid is a water-soluble vitamin capable of directly donating electrons to reactive oxygen species, attenuating electrical remodeling, and cardiac dysfunction in patients undergoing cardiac surgery (CS), considered one of the most effective defenses against free radicals in the blood, thus being one of the first antioxidants consumed during oxidative stress. The aim of this review is to assess the effects of perioperative administration of vitamin C in CS patients. A comprehensive literature search was conducted in order to identify prospective cohort studies and/or randomized controlled trials reporting on the perioperative effects of vitamin C among adult patients undergoing CS. Studies published between January 1980 to December 2022 were included in our search, resulting in a total of 31 articles that met all our inclusion criteria. There seems to be a beneficial effect of vitamin C supplementation in arrhythmias such as in postoperative atrial fibrillation, reduction of ICU length of stay, and hospital length of stay, reduction in postoperative ventilation time, in inotropic demand, and in postoperative fatigue. Vitamin C can act as a scavenger of free radicals to decrease the peroxidation of the lipids present in the cell membrane, and to protect the myocardium postoperatively from ischemia/reperfusion injury, thus attenuating oxidative stress and inflammation. It represents a readily available and cost-effective strategy that could improve the outcome of patients undergoing CS, by reducing the risk of serious cardiovascular adverse events, both perioperatively and postoperatively.
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Affiliation(s)
| | | | | | - Konstantina Aggeli
- Department of Cardiology, ‘Hippocrates’ General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Elpidoforos S. Soteriades
- Healthcare Management Program, School of Economics and Management, Open University of Cyprus, Nicosia, Cyprus
- Department of Environmental Health, Environmental and Occupational Medicine and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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Mendonça JDS, Guimarães RDCA, Zorgetto-Pinheiro VA, Fernandes CDP, Marcelino G, Bogo D, Freitas KDC, Hiane PA, de Pádua Melo ES, Vilela MLB, do Nascimento VA. Natural Antioxidant Evaluation: A Review of Detection Methods. Molecules 2022; 27:3563. [PMID: 35684500 PMCID: PMC9182375 DOI: 10.3390/molecules27113563] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 11/19/2021] [Accepted: 11/24/2021] [Indexed: 02/04/2023] Open
Abstract
Antioxidants have drawn the attention of the scientific community due to being related to the prevention of various degenerative diseases. The antioxidant capacity has been extensively studied in vitro, and different methods have been used to assess its activity. However, the main issues related to studying natural antioxidants are evaluating whether these antioxidants demonstrate a key role in the biological system and assessing their bioavailability in the organism. The majority of outcomes in the literature are controversial due to a lack of method standardization and their proper application. Therefore, this study aims to compile the main issues concerning the natural antioxidant field of study, comparing the most common in vitro methods to evaluate the antioxidant activity of natural compounds, demonstrating the antioxidant activity in biological systems and the role of the main antioxidant enzymes of redox cellular signaling and explaining how the bioavailability of bioactive compounds is evaluated in animal models and human clinical trials.
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Affiliation(s)
- Jenifer da Silva Mendonça
- Graduate Program in Health and Development in the Central-West Region of Brazil, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil; (J.d.S.M.); (R.d.C.A.G.); (V.A.Z.-P.); (G.M.); (D.B.); (K.d.C.F.); (P.A.H.); (E.S.d.P.M.)
| | - Rita de Cássia Avellaneda Guimarães
- Graduate Program in Health and Development in the Central-West Region of Brazil, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil; (J.d.S.M.); (R.d.C.A.G.); (V.A.Z.-P.); (G.M.); (D.B.); (K.d.C.F.); (P.A.H.); (E.S.d.P.M.)
| | - Verônica Assalin Zorgetto-Pinheiro
- Graduate Program in Health and Development in the Central-West Region of Brazil, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil; (J.d.S.M.); (R.d.C.A.G.); (V.A.Z.-P.); (G.M.); (D.B.); (K.d.C.F.); (P.A.H.); (E.S.d.P.M.)
| | - Carolina Di Pietro Fernandes
- Group of Spectroscopy and Bioinformatics Applied Biodiversity and Health (GEBABS), Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil;
| | - Gabriela Marcelino
- Graduate Program in Health and Development in the Central-West Region of Brazil, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil; (J.d.S.M.); (R.d.C.A.G.); (V.A.Z.-P.); (G.M.); (D.B.); (K.d.C.F.); (P.A.H.); (E.S.d.P.M.)
| | - Danielle Bogo
- Graduate Program in Health and Development in the Central-West Region of Brazil, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil; (J.d.S.M.); (R.d.C.A.G.); (V.A.Z.-P.); (G.M.); (D.B.); (K.d.C.F.); (P.A.H.); (E.S.d.P.M.)
| | - Karine de Cássia Freitas
- Graduate Program in Health and Development in the Central-West Region of Brazil, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil; (J.d.S.M.); (R.d.C.A.G.); (V.A.Z.-P.); (G.M.); (D.B.); (K.d.C.F.); (P.A.H.); (E.S.d.P.M.)
| | - Priscila Aiko Hiane
- Graduate Program in Health and Development in the Central-West Region of Brazil, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil; (J.d.S.M.); (R.d.C.A.G.); (V.A.Z.-P.); (G.M.); (D.B.); (K.d.C.F.); (P.A.H.); (E.S.d.P.M.)
| | - Elaine Silva de Pádua Melo
- Graduate Program in Health and Development in the Central-West Region of Brazil, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil; (J.d.S.M.); (R.d.C.A.G.); (V.A.Z.-P.); (G.M.); (D.B.); (K.d.C.F.); (P.A.H.); (E.S.d.P.M.)
- Group of Spectroscopy and Bioinformatics Applied Biodiversity and Health (GEBABS), Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil;
- School of Medicine, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil;
| | | | - Valter Aragão do Nascimento
- Graduate Program in Health and Development in the Central-West Region of Brazil, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil; (J.d.S.M.); (R.d.C.A.G.); (V.A.Z.-P.); (G.M.); (D.B.); (K.d.C.F.); (P.A.H.); (E.S.d.P.M.)
- Group of Spectroscopy and Bioinformatics Applied Biodiversity and Health (GEBABS), Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil;
- School of Medicine, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil;
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