Can vitamin supplements help critically ill patients recover from their injuries? A collaborative study by Harborview surgeons and dietitians is evaluating the efficacy of anti-oxidant vitamin supplementation in intensive care unit (ICU) patients at Harborview.
Many critically ill trauma patients develop acute respiratory distress syndrome (ARDS), an uncontrolled inflammatory response in the lung leading to prolonged ventilator dependency, a longer ICU stay and higher mortality.
"It doesn't seem to matter what type of injury you have, if it's severe enough, you can develop ARDS," says Dr. Avery B. Nathens, University of Washington fellow in trauma and critical care based at Harborview. "Vitamins C and E have anti-oxidant properties and a number of preliminary studies have demonstrated that they can limit tissue injury caused by oxidants, suggesting that supplementation with these vitamins may prevent the development of ARDS."
Now halfway through, the one-year study has so far found that many trauma patients admitted to Harborview have lower than normal levels of vitamins C, possibly due to poor intake of the vitamin in their daily diet, says Nathens.
To evaluate whether antioxidant vitamin supplementation reduces the chances of developing ARDS, all general surgical patients entering Harborview's ICUs for a minimum of 48 hours will receive either standard amounts of the vitamins or IV supplementation with vitamin C in combination with vitamin E within 24 hours of admission. Patients with head injuries, sickle cell anemia and those taking the anticoagulant Coumadin are excluded from study enrollment.
So far more than 100 patients out of an expected total of 300 patients have taken part. As patients enter the study at the time of ICU admission, any individual may be withdrawn from the study at the request of their next of kin or their physician. Principle investigators are Dr. Ronald Maier, UW professor of surgery; Dr. Gregory Jurkovich, UW professor of surgery; and Nathens.
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