Resuscitation Fluid Requirements in Burn Injury Patients Using Intravenous Vitamin C: An Evidence Based Case Report
Abstract
Background: Based on the Guideline of European Society for Clinical Nutrition and Metabolism (ESPEN) in 2013, vitamin C is an additional therapy for burn patients during the resuscitation process and reduce the amount of fluid resuscitation but still needs further evidence. This study aims to find the effect of intravenous vitamin C administration to reduce the fluid requirements during first 24 hours resuscitation in burn patients.Methods: Electronic Literature search were performed in PubMed, Cochrane, Scopus and ProQuest databases. Hand searching was also performed. MesH Term was used in PubMed database searching. All literature obtained was screened based on inclusion and exclusion criteria.Results: Three articles were selected based on the eligibility criteria. Two Randomized Controlled Trial / RCT studies concluded that intravenous vitamin C administration reduced resuscitation fluid requirements in burn patients. But in the case control study there was no significant difference in resuscitation fluid requirements between the two groups. Other study reported that there were significant differences in resuscitation fluid requirements between the two groups. Both RCT studies did not use the blinding method and explained the side effects of therapy. A case control study reported an increase in cases of acute kidney failure in the vitamin C group compared to control (23% vs 7%) although it was not statistically significant.Conclusions: Intravenous vitamin C can reduce the resuscitation fluid requirements in the first 24 hours in burn patients (grade C recommendation).Downloads
References
Wardhana A, Basuki A, Prameswara ADH, Rizkita DN, Andarie AA, Canintika AF. The epidemiology of burns in Indonesia’s national referral burn center from 2013 to 2015. Burns Open. 2017;1:67–73.
Smolle C, Cambiaso-daniel J, Forbes AA, Wurzer P, Branski LK, Huss F, et al. Recent trends in burn epidemiology worldwide: A systematic review. 2018;43:249–57.
Cheri T. Emergency management of severe burns (EMSB). Albany creek: ANZBA; 2013.
Klein MB, Hayden D, Elson C, Nathens AB, Gamelli RL, Gibran NS, et al. The association between fluid administration and outcome following major burn: A multicenter study. Ann Surg. 2007;245:622–8.
Saffle JR. The phenomenon of “fluid creep” in acute burn resuscitation. J Burn Care Res. 2007;28:382–95.
Parker WH, Rhea EM, Qu ZC, Hecker MR, May JM. Intracellular ascorbate tightens the endothelial permeability barrier through Epac1 and the tubulin cytoskeleton. Am J Physiol - Cell Physiol. 2016;311:C652–62.
Hagel AF, Layritz CM, Hagel WH, Hagel HJ, Hagel E, Dauth W, et al. Intravenous infusion of ascorbic acid decreases serum histamine concentrations in patients with allergic and non-allergic diseases. Naunyn Schmiedebergs Arch Pharmacol. 2013;386:789–93.
Rousseau AF, Losser MR, Ichai C, Berger MM. ESPEN endorsed recommendations: Nutritional therapy in major burns. Clin Nutr. 2013;32:497–502.
Tanaka H, Matsuda T, Miyagantani Y, Yukioka T, Matsuda H, Shimazaki S. Reduction of resuscitation fluid volumes in severely burned patients using ascorbic acid administration: A randomized, prospective study. Arch Surg. 2000;135:326–31.
Nakajima M, Kojiro M, Aso S, Matsui H, Fushimi K, Kaita Y, et al. Effect of high-dose vitamin C therapy on severe burn patients: A nationwide cohort study. Crit Care. 2019;23:1–8.
Qin FJ, Hu XH, Chen Z, Chen X, Shen YM. Protective effects of tiopronin against oxidative stress in severely burned patients. Drug Des Devel Ther. 2019;13:2827–32.
Lin J, Falwell S, Greenhalgh D, Palmieri T, Sen S. High-dose ascorbic acid for burn shock resuscitation may not improve outcomes. J Burn Care Res. 2018;39:708–12.
Kahn SA, Beers RJ, Lentz CW. Resuscitation after severe burn injury using high-dose ascorbic acid: A retrospective review. J Burn Care Res. 2011;32:110–7.
ClinicalTrial.gov [Internet]. Bethesda (MD): National Library of Medicine (US). 2011 Dec 20-Indentifier NCT00350077, The Effect of High Dose Vitamin C in Burn Patients; 2006 Jul 10 [cited 2020 Feb 29]; [about 5 screens]. Available from: https://clinicaltrials.gov/ct2/show/NCT00350077
ClinicalTrial.gov [Internet]. Bethesda (MD): National Library of Medicine (US). 2019 Mar 6- . Indentifier NCT01587261, Vitamin C for Severe Thermal Injuries; 2012 Apr 30 [cited 2020 Feb 29]; [about 5 screens]. Available from: https://clinicaltrials.gov/ct2/show/ NCT01587261
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