Effect of Intravenous Injection of Vitamin C on Postoperative Pulmonary Complications in Patients Undergoing Cardiac Surgery: A Double-Blind, Randomized Trial

Abstract

Purpose

In this study, the effect of intravenous vitamin C during surgery on the incidence of postoperative pulmonary complications (PPCs) in patients undergoing cardiopulmonary bypass and cardiac surgery was observed, and its protective effect on the lungs was evaluated to provide a reference for clinical medication.

Patients and Methods

Patients undergoing cardiac surgery under cardiopulmonary bypass (CPB) were selected. The patients were divided into group A and group C by random sequence. Patients in group A received intravenous vitamin C 1 g 10 minutes after induction of anesthesia, 10 minutes before cardiac reanimation and at the moment of sternal closure. Patients in group C were intravenously injected with the same volume of saline at the same time. The primary outcome was the postoperative pulmonary complication severity score. Other outcomes were the incidence of PPCs, awakening time, extubation time, length of ICU stay, length of hospital stay, adverse events, oxygenation index (PaO₂/FiO₂), alveolar arterial oxygen partial pressure difference (A-aDO₂), dynamic lung compliance (Cd) and static lung compliance (Cs).

Results

Seventy patients completed the study. Compared to group C, the postoperative pulmonary complication score [2(2–3) vs 2(1–2); P=0.009] and the incidence of postoperative pulmonary complications (32.43% vs 12.12%; P =0.043) were lower in group A. There were no significant differences in awakening time, extubation time, length of ICU stay, length of hospital stay, adverse events, PaO₂/FiO₂, A-aDO₂, Cs, and Cd between the two groups (P>0.05).

Conclusion

In summary, this small randomized trial including low-risk cardiac surgery patients shows that intravenous vitamin C may safely be administered and may be helpful to prevent PPCs after cardiac surgery.

Keywords:

• cardiac surgery
• cardiopulmonary bypass
• postoperative pulmonary complications
• vitamin C

Acknowledgments

The authors thank Dr. Liu for his support in conducting this study and the colleagues of the group for their cooperation in data collection. This work was supported by the Department of Anesthesiology, Affiliated Hospital of Xuzhou Medical University. No commercial funding was received.

Data Sharing Statement

We will share all of the individual de-identified participant data that underlie the results reported in this article. Other study-related documents, including study protocol and statistical analysis plan, will be made available. Data are available indefinitely at https://doi.org/10.6084/m9.figshare.11986980.v1. Anyone who wishes to access the data can acquire them immediately following publication and no end date. For further data, proposals should be directed to [email protected] to Dr. Wang.

Disclosure

The authors report no conflicts of interest in this work.