Evaluation of Ascorbic Acid Adjuvant Therapy and Oxidative Stress Parameters in Burns Patients

Abstract

Background: Burns trauma is associated with considerable morbidity and mortality. Resuscitation of burns patients with high-dose of Ascorbic acid has shown potential for mitigating the injury, but the optimal dose for this indication is unknown.
 Aim: This study aimed to evaluate the impact of adjuvant therapy with intravenous Ascorbic acid (6g over 24 hours) on indicators of oxidative stress in patients with major burns.
 Materials and Methods: We conducted a randomized placebo-controlled study on patients with major burns who presented at the National Orthopaedic Hospital, Enugu, Nigeria between August 2017 and July 2020. Each patient in the treatment group received intravenous Ascorbic acid, 6g over 24 hours, while those in the placebo group received Normal saline in the resuscitation fluid. Oxidative stress evaluation was based on measurement of total antioxidant capacity and malondialdehyde in the participants. The level of statistical significance was determined by a p value of <0.05.
 Results: The study was conducted on 37 burns patients and 15 healthy subjects. At presentation, the burns patients had significantly lower total antioxidant capacity; P=0.006, and higher serum malondialdehyde; P=0.040, compared to the healthy volunteers. The decrease in serum malondialdehyde in the burns patients treated with high-dose Ascorbic acid; 0.9±0.8 nmol/mL, was greater than that in those treated with placebo; 0.3±1.4 nmol/mL. Similarly the increase in total antioxidant capacity in the burns patients treated with high-dose Ascorbic acid; 151.7±116.5 µmol/L was greater than that in those treated with placebo; 58.4±219.1 µmol/L. However these effects weren’t statistically significant.
 Conclusion: Intravenous Ascorbic acid at a dose of 6g over 24 hours did not significantly alter the indicators of oxidative stress in the burns patients, under the prevailing conditions of the study.

Burn Wound Healing: Clinical Complications, Medical Care, Treatment, and Dressing Types: The Current State of Knowledge for Clinical Practice

“…Therefore, oxidative stress is a state of imbalance between the action of RTF and the biological ability to quickly detoxify reactive intermediates and repair the damage that has occurred. Direct quantification of RTF is currently a major, but difficult, challenge due to the very short half-life of radicals and their extremely low concentrations in biological systems [65]. In the case of burns, RTF is an important factor that can increase vascular permeability and peroxidation of the plasma membrane lipids, and can cause local or systemic inflammation [66].…”

“…In the case of burns, RTF is an important factor that can increase vascular permeability and peroxidation of the plasma membrane lipids, and can cause local or systemic inflammation [66]. Lipid peroxidation is the leading mechanism of RTF cell damage due to the formation of aldehydes such as malondialdehyde (MDA) [65]. This compound is widely used as a biomarker in lipid peroxidation due to its reaction with thiobarbituric acid (TBA).…”