Intravenous Infusion Of Vitamin Research Articles

Combined treatment with vitamin C, hydrocortisone and thiamine does not attenuate morbidity and mortality of septic sheep

BackgroundSepsis is associated with a highest mortality rate in the ICU. Present study tests the efficacy of combined therapy with vitamin C, hydrocortisone and thiamine (combined therapy) in the ovine model of sepsis induced by Pseudomonas aeruginosa. In this study, sepsis was induced in sheep by instillation of Pseudomonas aeruginosa (1 × 1011 CFU) into the lungs via bronchoscope, under anesthesia. Nine hours after injury, intravenous infusion of vitamin C (0.75 g every 6 h), hydrocortisone (25 mg every 6 h), and thiamine (100 mg every 12 h) or saline was given to the treatment and control groups. Cardiopulmonary variables were recorded.ResultsThe survival rate was 16.7% in control and 33.3% in treatment groups. In the control group, mean arterial pressure dropped from 93.6 ± 8.6 to 75.5 ± 9.7 mmHg by 9 h, which was not affected by the combined therapy. Pulmonary dysfunction was not attenuated by the combined therapy either. The combined therapy had no effect on increased extravascular lung water content and fluid effusion into thoracic cavity. The bacterial number in the bronchoalveolar lavage fluid was significantly increased in the treatment group than the control group. The blood bacterial number remained comparable between groups.ConclusionsCombined vitamin C, hydrocortisone, and thiamine did not attenuate severity of ovine sepsis.

Vitamin C for Cardiac Protection during Percutaneous Coronary Intervention: A Systematic Review of Randomized Controlled Trials.

Percutaneous coronary intervention (PCI) is the preferred treatment for acute coronary syndrome (ACS) secondary to atherosclerotic coronary artery disease. This nonsurgical procedure is also used for selective patients with stable angina. Although the procedure is essential for restoring blood flow, reperfusion can increase oxidative stress as a side effect. We address whether intravenous infusion of vitamin C (VC) prior to PCI provides a benefit for cardioprotection. A total of eight randomized controlled trials (RCT) reported in the literature were selected from 371 publications through systematic literature searches in six electronic databases. The data of VC effect on cardiac injury biomarkers and cardiac function were extracted from these trials adding up to a total of 1185 patients. VC administration reduced cardiac injury as measured by troponin and CK-MB elevations, along with increased antioxidant reservoir, reduced reactive oxygen species (ROS) and decreased inflammatory markers. Improvement of the left ventricular ejection fraction (LVEF) and telediastolic left ventricular volume (TLVV) showed a trend but inconclusive association with VC. Intravenous infusion of VC before PCI may serve as an effective method for cardioprotection against reperfusion injury.

P941Acute effects of electronic hookah smoking on endothelial function, inflammation and oxidative stress

Abstract Background Electronic nicotine delivery systems (ENDS) are a new rapidly growing global epidemic. More recently, electronic (e-) hookahs, have increased in popularity in the United States, with the greatest uptake by young female adults, who endorse marketing claims that these products are safer alternatives to traditional hookah tobacco smoking. Unlike other ENDS such as e-cigarettes, e-hookah bowls are used through traditional waterpipes, allowing the vapor–containing aerosolized nicotine, propylene glycol, glycerin, and flavorings–to pass through a water-filled basin, before it is inhaled through the user's mouth. Contributing to e-hookah bowls' popularity is the belief that e-hookah flavored smoke is detoxified as it passes through the water-filled basin, rendering e-hookah a safer tobacco alternative. However, an e-hookah bowl delivers flavored nicotine by creating a vapor of fine (<2.5 μm) and ultrafine particles (<0.1 μm) that could induce vascular toxicity. Purpose To test the acute effect of electronic hookah smoking on endothelial function, inflammation and oxidative stress. Methods In 17 healthy young adults who smoke hookah but not cigarettes (age 26±1 years, mean±SE; BMI 23.8±0.7 kg-m2), we measured brachial artery flow-mediated dilation (FMD) before and after a 30-minute e-hookah bowl smoking. To test for inflammatory mediation, pro-inflammatory cytokines hsCRP, TNF-α, and fibrinogen were collected before and after smoking. To test for oxidative stress mediation, on a separate day, the acute effect of e-hookah smoking on FMD was examined after intravenous infusion of Vitamin C, an effective antioxidant. Plasma nicotine levels were collected before and after the smoking session. The same measurements were performed before and after a subset of subjects (n=8) performed a sham-smoking control study. Results E-hookah smoking, which markedly increased plasma nicotine (Δ plasma nicotine: +6.07±1.87, p=0.018) and mean arterial pressure (Δ mean arterial pressure: +12±2 mm Hg, p<0.001), acutely decreased FMD from 8.04±0.68 to 6.14±0.52%Δ, p<0.001, indicating impaired endothelial function. While fibrinogen and TNF-α levels increased from 225.31±7.41 to 236.77±9.79, p=0.026 and from 0.80±0.04 to 0.87±0.05, p=0.036, respectively, hsCRP did not change (P=ns). Vitamin C administration prevented the acute FMD impairment by e-hookah smoking (P=ns). All parameters were unchanged during sham-control studies. Conclusions In contrast to the widespread popular belief that e-hookah is safe, the data herein show that each e-hookah session constitutes a potent vascular toxin acutely impairing endothelial function and inducing an inflammatory state. That the acute impairment in FMD with electronic hookah is restored with administration of the potent antioxidant Vitamin C suggest that elevated vascular oxidative stress as a key mechanism involved. These new data provide evidence to counter claims that e-hookah is a safer tobacco alternative. Acknowledgement/Funding This work was funded by the National Institutes of Health, National Heart, Lung, and Blood Institute 1R21HL145002-01 to MRH.

Oxygen is rocket fuel for the human brain; a radical perspective!

Oxygen is rocket fuel for the human brain; a radical perspective!

OP033 BIOAVAILABILITY OF ANTIOXIDANTS VARIES WITH NUTRITIONAL STATUS IN ADOLESCENTS?

Rationale: The adequate dose and the effectiveness of vitamin C administration in postsurgical patients are not clear. We investigated an adequate vitamin C dose during PPN therapy in patients after gastrointestinal surgery by measuring blood concentrations and urine excretions of vitamin C. We also sought to identify the effects of vitamin C on the oxidative status. Methods: In a randomized trial, 2 days after undergoing gastrointestinal surgery, 16 patients started to receive a 5-day continuous intravenous infusion of vitamin C, either 100 or 500mg/day. Blood concentrations of vitamin C and inflammatory and immunological parameters were measured preoperatively, next day of surgery, and 3 and 5 days after starting administration of vitamin C (Day3 and Day5). Also, excretions of vitamin C and oxidative stress markers in 24-hour, cumulative urine samples, collected and stored under light protection at 0oC were measured on Day3 and Day5. Results: Mean blood vitamin C concentration decreased markedly after surgery. The concentration returned to normal on Day 3 and on Day 5 in the 500-mg group and only on Day 5 in the 100-mg group. Concentrations differed significantly between the groups on Day 3 and on Day 5 (P< 0.001 for both days). Urinary vitamin C excretion was above normal on both days in the 500mg group, but it never reached normal in the 100mg group (P< 0.001 for both days). Urinary excretion of 8-isoprostane, a marker of oxidative stress, was significantly lower in the 500-mg than in the 100-mg group on Day3 (P= 0.002). Conclusion: Vitamin C dose of 500mg/day, not 100mg/ day, is adequate for patients undergoing gastrointestinal surgery and receiving PPN therapy. Vitamin C may decrease postsurgical oxidative stress.

Effects of vitamin C infusion and vitamin E-coated membrane on hemodialysis-induced oxidative stress

Chronic hemodialysis (HD) patients manifest anemia and atherosclerosis with associated oxidative stress. We explored whether intravenous infusion of vitamin C (VC) and/or use of vitamin E (VE)-coated dialysis membrane could palliate HD-evoked oxidative stress. Eighty patients undergoing chronic HD were enrolled and randomly assigned into four groups: HD with intravenous VC (n=20), HD with VE-coated dialyzer (n=20), HD with both (n=20), and HD with neither (n=20). We evaluated oxidative stress in blood and plasma, erythrocyte methemoglobin/ferricyanide reductase (red blood cells (RBC)-MFR) activity, plasma methemoglobin, and pro-inflammatory cytokines in these patients. All patients showed marked increases (14-fold) in blood reactive oxygen species (ROS) after HD. The types of ROS were mostly hydrogen peroxide, and in lesser amounts, O2*- and HOCl. HD resulted in decreased plasma VC, total antioxidant status, and RBC-MFR activity and increased plasma and erythrocyte levels of phosphatidylcholine hydroperoxide (PCOOH) and methemoglobin. Intravenous VC significantly palliated HD-induced oxidative stress, plasma and RBC levels of PCOOH, and plasma methemoglobin levels and preserved RBC-MFR activity. The VE-coated dialyzer effectively prevented RBCs from oxidative stress, although it showed a partial effect on the reduction of total ROS activity in whole blood. In conclusion, intravenous VC plus a VE-coated dialyzer is effective in palliating HD-evoked oxidative stress, as indicated by hemolysis and lipid peroxidation, and by overexpression of proinflammation cytokines in HD patients. Using VE-coated dialyzer per se is, however, effective in reducing lipid peroxidation and oxidative damage to RBCs.

Reduction of oxidative stress augments natriuretic effect of furosemide in moderate heart failure

Background The significance of antioxidant therapy in heart failure has not been fully examined. This study evaluated whether vitamin C has beneficial effects on renal function or augments the renal effects of furosemide in patients with heart failure. Methods There were 2 protocols. In protocol 1, plasma level of thiobarbituric acid-reactive substances (TBARS) and renal function were assessed before and after intravenous infusion of vitamin C or placebo in 8 patients with moderate congestive heart failure (CHF) treated with enalapril. In protocol 2, a randomized crossover study was performed in patients with moderate CHF treated with either an ACE inhibitor (enalapril) (n = 10) or an angiotensin II receptor antagonist (losartan) (n = 9) and in asymptomatic patients with impaired left ventricular function treated with enalapril (n = 8). TBARS and renal function were assessed before and after intravenous infusion of furosemide alone, coinfusion of furosemide with placebo and vitamin C, or coinfusion of furosemide with vitamin C and a kallikrein inhibitor (nafamostat mesilate). Results In protocol 1, although vitamin C reduced TBARS, it did not affect renal function. In protocol 2, TBARS was higher in patients with moderate CHF than in asymptomatic patients. Vitamin C augmented natriuretic effect of furosemide (from 179 ± 98 to 192 ± 104 μmol/min, P < .01) only in patients with moderate CHF treated with enalapril but not in the other 2 groups. Nafamostat mesilate prevented this augmentation. Conclusions In patients with CHF treated with enalapril, counteraction of the increased oxidative stress by vitamin C may contribute to the augmented natriuretic effect of furosemide through the renal kinin-nitric oxide pathway. (Am Heart J 2003;145:e2.)

Supranutritional administration of vitamins E and C improves oxidative stability of beef.

Vitamins E and C are important antioxidants in animals. Their antemortem activity continues to function in postmortem muscle (meat), where they have a critical role in maintaining quality in the food product. Dietary supplementation of vitamin E, and intravenous infusion of vitamin C immediately before harvest, are efficacious techniques for increasing the concentration of these vitamins in beef skeletal muscle. Meat with elevated levels of either and probably both of these antioxidant vitamins possesses greater stability of oxymyoglobin and lipid, which results in less discoloration and rancidity, respectively. A model is proposed for the redox relationships between myoglobin and phospholipid in beef with emphasis on vitamins E and C. Antemortem nutritional intervention appears to be a promising approach for improving the quality of fresh meat products subsequently obtained from livestock.