The effects of cardiovascular and orthopaedic surgery on vitamin concentrations: a narrative review of the literature and mechanisms of action

Abstract

Given the rise in worldwide chronic diseases, supplemented by an aging population, the volume of global major surgeries, encompassing cardiac and orthopedic procedures is anticipated to surge significantly. Surgical trauma can be accompanied by numerous postoperative complications and metabolic changes. The present review summarized the results from studies assessing the effects of orthopedic and cardiovascular surgery on vitamin concentrations, in addition to exploring the possible mechanisms associated with changes in concentrations. Studies have revealed a potentially severe depletion in plasma/serum concentrations of numerous vitamins following these surgeries acutely. Vitamins C, D and B1 appear particularly vulnerable to significant depletions, with vitamin C and D depletions consistently transpiring into inadequate and deficient concentrations, respectively. The possible multifactorial mechanisms impacting postoperative vitamin concentrations include changes in hemodilution and vitamin utilization, redistribution, circulatory transport and absorption. For a majority of vitamins, there has been a lack of investigation into the effects of both, cardiac and orthopedic surgery. Additionally, studies were predominantly restricted to short-term postoperative investigations, primarily performed within the first postoperative week of surgery. Overall, results indicated that further examination is necessary to determine the severity and clinical significance of the possible depletions in vitamin concentrations that ensue cardiovascular and orthopedic surgery.

Keywords:

• Vitamins
• surgery
• postoperative
• orthopedic
• cardiac

Disclosure statement

A. Scholey has held research grants from: Abbott Nutrition, Arla Foods, Australian Wine Research Institute, Bayer, Cognis, Cyvex, GlaxoSmithKline, Dairy Health Innovation Consortium, Ginsana, Kemin Foods, Martek, Masterfoods, Neurobrands, Naturex, Nestlé, Nutricia-Danone, Red Bull, Sanofi, Verdure Sciences, Wrigley Science Institute. A. Pipingas has held research grants from Enzo, Novasel, Clover, Gretals, Swisse Wellness, LifeVantage, Arla, Abbott Nutrition and has previously served as a member of the Scientific Advisory Panel for Swisse Wellness Pty Ltd. N. Travica has received funding from Deakin University for an Executive Dean’s Post-Doctoral Fellowship. K. Ried, A. Sali and I. Hudson declare no conflict of interest.

Funding

The author(s) reported there is no funding associated with the work featured in this article.