Vitamins C, E Aid Recovery from Surgery in Critically Ill

Supplementation with vitamins C and E can reduce the incidence of life-threatening complications in critically ill surgical patients, according to a report in the Annals of Surgery (2002;236:814–22). The results of this study suggest that this simple, safe, and inexpensive treatment might help save the lives of people who have sustained serious injuries, while at the same time reducing the cost of medical treatment.

Five hundred ninety-five people admitted to a surgical intensive care unit (ICU), 91% of whom were victims of trauma, were randomly assigned to receive standard care (control group) or standard care plus vitamins C and E. Vitamin E was given orally in the amount of 1,000 IU three times per day, and vitamin C was given intravenously in the amount of 1,000 mg three times per day.

Treatment was continued until the person was discharged from the ICU, or after 28 days, whichever was shorter. The incidence of multiple organ failure was significantly lower (by 57%) in the group receiving antioxidants than in the control group (2.7% vs. 6.1%). In addition, the average length of stay in the ICU was significantly lower (by 17%) in the antioxidant group. After 28 days, the mortality rate was 44% lower in the antioxidant group than in the control group (1.3% vs. 2.4%), but this difference was not statistically significant.

Critically ill surgical patients frequently develop severe and potentially fatal complications, such as pneumonia or multiple organ failure, days or weeks after major surgery. There is evidence that these complications are mediated, at least in part, by highly reactive oxygen-derived compounds known as free radicals, which are capable of causing damage to various tissues and organs of the body. Antioxidants such as vitamins C and E, selenium, N-acetylcysteine (NAC), and glutathione can prevent some of the damage induced by free radicals.

Although the amounts of vitamin C and vitamin E used in the new study would be considered fairly large for a healthy person, it is possible that even larger amounts would be needed to exert an optimal effect in critically ill individuals. In addition, as antioxidants work in the body as a team, it is likely that using a broad spectrum of antioxidants would be more effective than using only two, as in the new study. Now that researchers have demonstrated a beneficial effect of antioxidants in critically ill surgical patients, the stage is set for additional research to determine the optimal amounts and combinations of antioxidants to administer.

Alan R. Gaby, MD, an expert in nutritional therapies, testified to the White House Commission on CAM upon request in December 2001. Dr. Gaby served as a member of the Ad-Hoc Advisory Panel of the National Institutes of Health Office of Alternative Medicine. He is the author of Preventing and Reversing Osteoporosis (Prima, 1994), and co-author of The Natural Pharmacy, 2nd Edition (Healthnotes, Prima, 1999), the A–Z Guide to Drug-Herb-Vitamin Interactions (Healthnotes, Prima, 1999), Clinical Essentials Volume 1 and 2 (Healthnotes, 2000), and The Patient’s Book of Natural Healing (Prima, 1999). A former professor at Bastyr University of Natural Health Sciences, in Kenmore, WA, where he served as the Endowed Professor of Nutrition, Dr. Gaby is the Chief Medical Editor for Healthnotes, Inc.

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