Abstract
There is association between lung contusion (lC) and a progressive inflammatory response. The protective effect of vitamin C and vitamin E, as strong free radical scavengers on favourite outcome of (LC) in animal models, has been confirmed.Designto evaluate the effect of vitamins, E and C on arterial blood gas (ABG) and ICU stay, in (LC), with injury severity score (ISS) 18 ± 2, due to blunt chest trauma.MethodsThis study was a randomized, double-blind, placebo-controlled clinical trial. Patients with (ISS) 18 ± 2 blunt chest trauma, who meet criteria, participated in the study. A total of 80 patients from Feb 2015 to Jun2018and were randomly divided into 4 groups. Patients received intravenous vitamin E (1000IU mg), was (group I); intravenous vitamin C (500) (group II). Vitamin C + vitamin E = (group III), and intravenous distilled water = (control group) or (group IV). ABG, serum cortisol, and CRP levels were determined at baseline, 24 h and 48 h after the intervention.Resultsa significant decrease in ICU stay in group III compared to other groups (p < 0.001). Co-administration of vitamin C and vitamin E showed significant increases pH (values to reference range from acidemia”), oxygen pressure, and oxygen saturation in group III compared to other groups (p < 0.001). A significant decrease in carbon dioxide pressure was also detected after receiving vitamin C and vitamin E in group III, compared to other groups (p < 0.001). There was no significant difference cortisol and CRP levels between groups after the intervention.ConclusionCo-administration of vitamin C and vitamin E, improve the ABG parameters and reduce ICU stay.
Highlights
Lung contusion can promote systemic inflammatory activation and leads acute respiratory failure due to alveolar collapse and impaired fluid clearance [4]. the exact mechanisms of LC are not yet understood, and many efforts have been made to describing pathophysiological changes after blunt trauma, the association between LC and a progressive inflammatory response which mediated by local and systemic immunological alteration, has been well described [5,6]
This study, conducted in Trauma Research Center, Level 3 Trauma Center registry, on patients admitted in ICU surgery of complex teaching hospital, between Feb 2015 to Jun 2018 to assess the Protective Effect of Vitamin C and vitamin E on Arterial Blood Gas parameter and ICU length stay on patients, with diagnosis of pulmonary contusion due to blunt trauma
Turkey's Post hoc test showed significant difference between group III with control(P > 0.5), but there is no difference between group I and control (P-value < 0.5).and no significant difference between parameters of pH، PO2، PCO2، O2sat, Cortisol, C - reactive protein (CRP) in the beginning of study in four groups (p = 0.03). (Normal Values and Acceptable Ranges of the arterial blood gas (ABG) Elements: Oxygen Saturation (93–100%) pH = 7.4 (7.35–7.45). pCO2 = 40 mmHg (35–45 mmHg). pO2 = 90 mmHg (80–100) mmHg.) (Normal Values of Morning serum cortisol (8am) 140–690 nmol/L Quantitative C-Reactive Protein (CRP) = 0.0–4.9 mg/L)
Summary
Lung contusion (LC), is the most frequent intrathoracic injury due to blunt chest trauma, despite improvement in treatment modalities, still has up to 20% mortality rate in severely thoracic trauma [1].The majority of (LC) patients have multiple injuries with thoracic trauma, while 10–20% of cases are affected in an isolated manner [2,3]. Lung contusion can promote systemic inflammatory activation and leads acute respiratory failure due to alveolar collapse and impaired fluid clearance [4]. the exact mechanisms of LC are not yet understood, and many efforts have been made to describing pathophysiological changes after blunt trauma, the association between LC and a progressive inflammatory response which mediated by local and systemic immunological alteration, has been well described [5,6].
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