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Surgery: Antioxidant Vitamins Prevent Complications

Antioxidant vitamins prevent certain complications of surgery.

According to a study published in the Annals of Surgery (2003;236: 814-822), giving antioxidant vitamins C and E to critically ill patients may lower their risk of developing certain complications after surgery.

Researchers found that trauma patients who received these antioxidant vitamins spent less time in the intensive care unit following surgery and were less likely to have multiple organ failure, which can occur weeks after surgery. They also spent less time on a mechanical ventilator.
The antioxidants did not result in differences in terms of pneumonia, lung function or kidney failure.
"The lack of adverse effects, coupled with the minimal expense, supports that this combination is a reasonable therapeutic intervention in critically (ill) surgical patients," conclude Dr. Avery B. Nathens from Harborview Medical Center in Seattle, Washington, and colleagues.
The study was funded through a grant from the Centers for Disease Control and Prevention and by Wyeth-Ayerst Laboratories. Wyeth is the parent company of Solgar Vitamins.
Why would antioxidant vitamins be expected to help? Antioxidants neutralize free radicals, and free radicals that are generated by an acute injury are thought to raise the risk of multiple organ failure among critically ill surgical patients. Studies have shown that patients admitted to the intensive care unit have lower blood levels of vitamins E and C, and lower blood levels of antioxidants have been linked with a higher risk of organ dysfunction.
To investigate whether antioxidants--compounds that neutralize damaging free radicals--could lower the risk of these complications, researchers randomly assigned patients to antioxidant vitamins or no additional treatment from the time they were admitted to the intensive care unit. The study continued until they left the unit or until 28 days had passed--whichever was shorter.
About 300 patients received vitamin E through a feeding tube and vitamin C intravenously every eight hours. Most of the patients were admitted for trauma, although some had serious infections.
Multiple organ failure occurred in 4% of patients overall, and those receiving antioxidant therapy were less likely to experience organ failure. Overall, 6% of patients not given antioxidants developed multiple organ failure compared with 3% of those given antioxidants.
There was no difference between the two groups in the rate of acute kidney failure, another complication of surgery for trauma patients.
"These data suggest the potential for benefit if antioxidants are administered prophylactically, before the onset of significant organ dysfunction and infection," the researchers conclude.


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