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Antioxidant therapy using high dose vitamin C: Reduction of postburn resuscitation fluid volume requirements

  • Société Internationale de Chirurgie—Manuscripts Presented at the 35th World Congress of the International Society of Surgery, Hong Kong, August 1993
  • Published:
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Abstract

Twenty-four guinea pigs with third degree burns over 70% of the body surface area were divided equally into four groups. At 0.5 hours postburn, all groups received Ringer's lactate solution (R/L) according to the Parkland formula. The infusion rate was then reduced to 25% of the Parkland formula at 1.5 hours postburn. Group 1 received only R/L, and groups 2, 3 and 4 received adjuvant vitamin C (14.2 mg/kg/hr) until 4, 8, and 24 hours postburn, respectively. The volume of R/L was reduced by that of vitamin C solution so that the hourly sodium and fluid intake in each group was the same. Groups 1 and 2 demonstrated higher hematocrit and lower cardiac output values than did group 3, suggesting hypovolemia and hemoconcentration in these groups. Group 3 showed hematocrit and cardiac output values equivalent to those in group 4. We conclude that high dose vitamin C infusion maintains hemodynamic stability in the presence of a reduced resuscitation fluid volume provided vitamin C is administered for a minimum of 8 hours postburn.

Résumé

Vingt-quatre cochons d'Inde brûlés au troisième degré à plus de 70% de leur surface corporelle ont été ensuite divisés en quatre groupes. Trente minutes après la brûlure, tous les animaux ont reçu une perfusion de Ringer lactate (R/L) selon la formule de Parkland. A 90 minutes, le débit de la perfusion a été réduite à 25% de la formule de Parkland. Les animaux dans le groupe I n'ont reçu que du R/L alors que les animaux des groupes 2, 3, et 4 ont reçu en plus de la vitamine C (14.2 mg/kg/hr), respectivement 4, 8, et 24 heures après leur brûlure. Le volume de R/L a été réduit proportionnellement de façon à ce que le volume total instillé chez chaque animal soit strictement le même. L'hématocrite et le débit cardiaque étaient plus élevés dans le groupe 1 et plus bas dans le groupe 2 par rapport au groupe 3 suggérant respectivement une hypovolémie et une hémoconcentration dans ces groupes. L'hématocrite et le débit cardiaque étaient similaires dans les groupes 3 et 4. Nous concluons que lorsque le volume de réanimation des brûlés est limité, l'infusion de vitamine C à haut dose est responsable de stabilité hémodynamique à condition qu'elle soit administrée au plus tard 8 heures après la brûlure.

Resumen

Un grupo de 24 curies con quemaduras de tercer grado sobre el 70% de la superficie corporal fueron divididos en 4 grupos. A las 0.5 horas postquemadura, todos los grupos recibieron lactato de Ringer (R/L) de acuerdo con la fórmula de Parkland. La tasa de infusión fue reducida luego a 25% de la fórmula de Parkland a las 1.5 horas postquemadura. El grupo 1 recibió R/L solamente y los grupos 2, 3 y 4 recibieron vitamina C coadyuvante (14.2 mg/kg/hr) hasta las 4, 8, y 24 horas postquemadura, respectivamente. El volumen de R/L fue reducido por el de la solución de vitamina C en tal forma que la ingesta horaria de sólido y de liquido fuera la misma en cada grupo. Los grupos 1 y 2 demostraron mayores valores de hematocrito y menores de gasto cardíaco en comparación con los animales en el grupo 3, lo cual sugiere hipovolemia y hemoconcentración en tales grupos. El grupo 3 demostró valores de hematocrito y de gasto cardiaco equivalentes a los del grupo 4. Nuestra conclusión es que la infusión de altas dosis de vitamina C mantiene la estabilidad hemodinámica en presencia de volúmenes reducidos de liquidos de reanimación, siempre y cuando se administre vitamina C por un mínimo de 8 horas postquemadura.

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Matsuda, T., Tanaka, H., Reyes, H.M. et al. Antioxidant therapy using high dose vitamin C: Reduction of postburn resuscitation fluid volume requirements. World J. Surg. 19, 287–291 (1995). https://doi.org/10.1007/BF00308640

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