December 02, 2016
Compared with a placebo or nonplacebo control, perioperative administration of ascorbic acid to patients undergoing cardiac surgery may reduce length of stay (LOS) in the intensive care unit (ICU) and at the hospital, claim researchers at the University of Connecticut, School of Pharmacy.
Postoperative atrial fibrillation (POAF) is highly prevalent in patients who undergo cardiac surgery, whether it is coronary artery bypass grafting (CABG) or valve replacement surgery. While the condition is often self-limiting, prolonged ICU and hospital LOS can be seen; stroke risk might also be elevated.
Some studies have suggested that perioperative use of antioxidant supplementation may prevent POAF, though these findings have not been verified. Therefore, William L Baker and Craig I Coleman performed a systematic review of studies examining the impact of ascorbic acid on POAF frequency and LOS. They published their results in the American Journal of Health-System Pharmacy.
A total of 11 studies involving patients who received CABG with or without valve replacement and ascorbic acid were identified and included in the analysis. Overall, pooled outcomes data revealed that treatment with ascorbic acid prophylaxis was associated with reductions in POAF frequency (odds ratio, 0.44; 95% confidence interval [CI], 0.32 to 0.61), intensive care unit (ICU) LOS (difference in means, −0.24 day; 95% CI, −0.45 to −0.03 day), and total hospital LOS (difference in means, −0.94 day; 95% CI, −1.65 to −0.23 day) compared with the control group who did not receive ascorbic acid. All findings were statistically significant.
“Overall, the meta-analysis demonstrated that the addition of ascorbic acid supplementation to the perioperative care of patients undergoing cardiac surgery significantly reduces the odds of POAF. The beneficial effects were similar whether ascorbic acid was given intravenously or orally and whether patients underwent CABG only or both CABG and valve surgery,” authors of the study concluded.
“These findings provide clinicians with another option for preventing the common and troublesome complication of POAF in cardiac surgery patients.”—Sean McGuire.