Effect of Ascorbic Acid on Postoperative Pulmonary Complications in Patients Undergoing Cardiac Surgery
- Conditions
- Postoperative Pulmonary Complications
- Interventions
- Drug: Saline
- Registration Number
- NCT03756727
- Lead Sponsor
- Xuzhou Medical University
- Brief Summary
Postoperative pulmonary complications(PPCs) including, but not limited to ,hypoxemia, pneumonia, ventilator-induced lung injury, and acute respiratory distress syndrome (ARDS),atelectasis,pleural effusion .PPCs may result in increased resources utilization, delayed mobilization, prolonged need of supplemental oxygen or mechanical ventilation,and a longer hospital stay.postoperative pulmonary complications are common after cardiac surgery, often increasing postoperative morbidity and mortality.The extracorporeal circulation,increased oxygen concentration inhaled and the development of massive atelectasis after open-chest surgery commonly activate lung inflammation, amplifying the harm Injury of pulmonary .Currently, plenty of interventions have been studied to prevent PPCs after surgery. Most of the recent research has focused on physical therapy such as lung-protective modes during intraoperative mechanical ventilation, Alveolar Recruitment, and respiratory muscle training.These therapies have a certain effect, but still not satisfactory.Ascorbic acid is an important cofactor in multiple enzymatic reactions where its main function is as a reducing agent.Studies have shown that ascorbic acid can reduce both ischemia-reperfusion injury and oxidative stress. Unfortunately, no studies examined whether Ascorbic acid can reduce PPCs.
- Detailed Description
The possible mechanisms of ascorbic acid to alleviate ischemia-reperfusion injury are as follows: 1 Ascorbic acid as a first-line antioxidant in plasma can reduce stress by eliminating excess Reactive oxygen species and reduce damage. 2 provides rapid electron transfer to react with superoxide and hydroxyl group to scavenge reactive oxygen released into the circulation. 3 Ascorbic acid can reduce lipid peroxidation and reduce lung injury caused by ischemia-reperfusion by scavenging oxygen free radicals. 4 Vitamin C can promote the production of cytokines by immune cells to reduce local inflammatory reactions and improve tissue microcirculation.The study aims to explore whether daily used Ascorbic acid in the perioperative period has a preventive effect on PPCs in patients undergoing cardiac surgery, and through short-term and long-term follow-up, to investigate the effect on post-hospitalization Prognosis .
Recruitment & Eligibility
- Status
- UNKNOWN
- Sex
- All
- Target Recruitment
- 110
- Age between 18-60 years old
- Selective cardiac surgery under cardiopulmonary bypass
- Emergency surgery
- Previous cardiac surgery
- Severe lung disease
- BMI<18 or >30
- Mean pulmonary arterial pressure >40 mmHg
- were allergic to ascorbic acid
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Control comparator group Saline the patients received 10ml saline at the night before surgery, during the surgery and five days after surgery. Ascorbic acid group Ascorbic Acid the patients received 2g of intravenous Ascorbic acid at the night before surgery, during the surgery and five days after surgery.
- Primary Outcome Measures
Name Time Method severity of postoperative pulmonary complications an average of 2 weeks Use the postoperative pulmonary complications score to record the severity. scored ranging from 0 to 5.Scored the severity once a day, record the highest score.
- Secondary Outcome Measures
Name Time Method incidence of postoperative pulmonary complications an average of 10 days incidence of postoperative pulmonary complications during hospital stay
extubation and wake time an average of 1 day length of extubation time,length of wake time
length of ICU stay and length of hospital stay an average of 10 days all patients transfer to ICU after surgery
PaO2/FiO2 1 day, 3 days,5 days post surgery Oxygenation index (PaO2/FiO2) in millimeter mercury column.
A-aDO2 1 day, 3 days,5 days post surgery alveolar-arterial oxygen tension difference (A-aDO2)
positive end expiratory pressure an average of 1 day positive end expiratory pressure in centimeter water column
Plateau pressure an average of 1 day Plateau pressure in centimeter water column
Peak airway pressure an average of 1 day Peak airway pressure in centimeter water column
post-hospitalization follow-up once a day till 30 days post-hospitalization record the incidence of postoperative pulmonary complications after hospital discharged.
lung compliance an average of 1 day lung compliance in Milliliter/ centimeter water column
Trial Locations
- Locations (1)
The Affiliated Hospital of Xuzhou Medical University
🇨🇳Xuzhou, Jiangsu, China