Vitamin C in the Management of Burn Patients: A Systematic Review of the Risks and Benefits

Siddiqi, Mahwash; Evans, Teresa; Guiab, Keren; Capron, Gweniviere; Roberts, Andrew; Messer, Thomas; Bokhari, Faran

doi:10.1177/00031348211054060

Cited by 3 publications

(1 citation statement)

References 14 publications

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“…However, several other small studies revealed no significant differences in Sequential Organ Failure Assessment (SOFA) scores, acute kidney injury or other hemodynamic parameters, complications, or mortality [30]. A systematic review concluded that the administration of vitamin C may lead to reduced fluid requirement, reduced wound healing time and in-hospital mortality and better outcomes when given at higher doses [30], with note made that very-high dose regimens may compromise renal outcomes via oxalate-induced obstructive nephropathy.…”

Section: Burnsmentioning

confidence: 99%

Vitamin C for all?

de Man,

Long,

Stoppe

2024

Current Opinion in Critical Care

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Purpose of review Vitamin C can be a potential adjunctive treatment option for critically ill individuals due to its pleiotropic effects as electron donor in many enzymatic reactions throughout the body. Recently, several important randomized controlled trials (RCTs) investigating vitamin C in critically ill patients have been published. Recent findings Two recent large RCTs administering high-dose vitamin C to patients with sepsis and COVID-19 showed signs of harm. Though performed at high standard, these trials had several limitations. Recent studies in cardiac surgery and burns showed decreased cardiac enzymes and improved clinical outcomes after cardiac surgery, and decreased fluid requirements, reduced wound healing time and in-hospital mortality after burns. Vitamin C may hold benefit in the management of other ischemia/reperfusion injury populations, including postcardiac arrest patients and after solid organ transplantation. Currently, covering basal vitamin C requirements during critical illness is recommended, though the exact dose remains to be determined. Summary Future work should address optimal vitamin C timing, since early versus late drug administration are likely distinct, and duration of therapy, where withdrawal-induced injury is possible. Additionally accurate assessment of body stores with determination of individual vitamin requirements is crucial to ascertain patient and subgroups most likely to benefit from vitamin C.

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Section: Burnsmentioning

confidence: 99%

Vitamin C for all?

de Man,

Long,

Stoppe

2024

Current Opinion in Critical Care

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Fluid Resuscitation and Cardiovascular Support in Acute Burn Care

Collier,

Gillenwater

2024

Clinics in Plastic Surgery

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Vitamin A-Induced Hypercalcemia in Burn Patients: A Case Study

Zeitouni

Zhu

Pang

et al. 2022

Journal of Burn Care &Amp; Research

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Vitamin and steroid supplementation such as oxandrolone are commonly given to speed the recovery process in severe burn injuries. Vitamin A is administered concurrently with steroids because of its pro-inflammatory and positive effects on wound healing. However, vitamin A supplementation warrants caution as hypercalcemia can result from vitamin A overdose. Our case involves an 18-year-old male injured in an oil field explosion who presented with 55% total body surface area partial and full thickness burns. Following successful resuscitation, he was given vitamin A, oxandrolone, vitamin C, and zinc sulfate as part of the standard vitamin supplementation. On hospital day 33, serum calcium levels were noted to be elevated and increased to 13 mg/dL a few days later. Parathyroid hormone and vitamin D levels were found to be within normal range, and urine analysis showed normal calcium excretion. Subsequent assessment of vitamin A levels revealed significantly elevated levels at 93 mcg/dL. Vitamin A supplementation was discontinued, and the patient was discharged on hospital day 42. At the one-month follow-up, serum calcium levels were normal, which links the hypercalcemia to vitamin A overdose. This case highlights the importance of considering vitamin A overdose as a cause for asymptomatic hypercalcemia with a normal parathyroid and vitamin D workup. While routine, vitamin A supplementation in burn patients calls for assessment of both serum calcium and vitamin A levels throughout the hospital stay to prevent hypercalcemia and its negative effects.

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Vitamin C in the Management of Burn Patients: A Systematic Review of the Risks and Benefits

Cited by 3 publications

References 14 publications

Vitamin C for all?

Vitamin C for all?

Fluid Resuscitation and Cardiovascular Support in Acute Burn Care

Vitamin A-Induced Hypercalcemia in Burn Patients: A Case Study

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