Vitamin C requirements in parenteral nutrition.

Détails

ID Serval
serval:BIB_7A13EFE78602
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Titre
Vitamin C requirements in parenteral nutrition.
Périodique
Gastroenterology
Auteur(s)
Berger M.M.
ISSN
1528-0012[electronic]
Statut éditorial
Publié
Date de publication
2009
Volume
137
Numéro
5 Suppl
Pages
70-78
Langue
anglais
Résumé
Some biochemical functions of vitamin C make it an essential component of parenteral nutrition (PN) and an important therapeutic supplement in other acute conditions. Ascorbic acid is a strong aqueous antioxidant and is a cofactor for several enzymes. The average body pool of vitamin C is 1.5 g, of which 3%-4% (40-60 mg) is used daily. Steady state is maintained with 60 mg/d in nonsmokers and 140 mg/d in smokers. Shocked surgical, trauma, and septic patients have a drastic reduction of circulating plasma ascorbate concentrations. These low concentrations require 3-g doses/d to restore normal plasma ascorbate concentrations, questioning the recommended PN dose of 100 mg/d. Determination of intravenous requirements is usually based on plasma concentrations, which are altered during the inflammatory response. There is no clear indicator of deficiency: serum or plasma ascorbate concentrations <0.3 mg/dL (20 micromol/L) indicates inadequate vitamin C status. On the basis of available pharmacokinetic data the 100 mg/d dose for patients receiving home PN and 200 mg/d for stable adult patients receiving PN are adequate, but requirements have been shown to be higher in perioperative, trauma, burn, and critically ill patients, paralleling oxidative stress. One recommendation cannot fit all categories of patients. Large vitamin C supplements may be considered in severe critical illness, major trauma, and burns because of increased requirements resulting from oxidative stress and wound healing. Future research should distinguish therapeutic use of high-dose ascorbic acid antioxidant therapy from nutritional PN requirements.
Mots-clé
Critically-Ill Patients, Ascorbic-Acid, Antioxidant Supplementation, Intensive-Care, Trace-Elements, Plasma, Pharmacokinetics, Trauma, Resuscitation, Transporters
Pubmed
Web of science
Création de la notice
24/11/2009 17:22
Dernière modification de la notice
03/03/2018 18:33
Données d'usage