Sander Rozemeijer, Angélique M E Spoelstra-de Man, Sophie Coenen, Bob Smit, Paul W G Elbers, Harm-Jan de Grooth, Armand R J Girbes, Heleen M Oudemans-van Straaten
Journal: Nutrients 2020;11(5):1031
PMID: 31071996
This cohort study examines Vitamin C status as a functional measure in critically ill ICU patients with those of healthy volunteers. Vitamin C deficiency is common in critically ill patients and so establishing vitC status in everyday clinical practise may help quickly identify patients who might benefit from vitamin C supplementation. Common practise is to measure plasma concentrations using timely and expensive high-pressure liquid chromatography. A new point-of-care device enables clinicians to measure the static oxidation-reduction potential (sORP), reflecting oxidative stress, and antioxidant capacity (AOC) as functional indicators of vitC status. This cohort study measured sORP and AOC in 211 samples taken from 103 subjects in stored plasma samples taken from two 2015 studies; an observational vitamin C status study and a randomized pharmacokinetics study. Normal plasma vitC concentrations were defined as 23 to 100 µmol/L whilst deficiency is defined as <11 µmol/L. The results showed that VitC concentrations were negatively associated with sORP (R2 = 0.816) and positively associated with AOC (R2 = 0.842) indicating oxidative stress and vitamin C deficiency. This novel device may help facilitate speedy measurement of vitC status to identify critically ill patients who could benefit from vitC therapy.
Vitamin C deficiency is common in critically ill patients. Vitamin C, the most important antioxidant, is likely consumed during oxidative stress and deficiency is associated with organ dysfunction and mortality. Assessment of vitamin C status may be important to identify patients who might benefit from vitamin C administration. Up to now, vitamin C concentrations are not available in daily clinical practice. Recently, a point-of-care device has been developed that measures the static oxidation-reduction potential (sORP), reflecting oxidative stress, and antioxidant capacity (AOC). The aim of this study was to determine whether plasma vitamin C concentrations were associated with plasma sORP and AOC. Plasma vitamin C concentration, sORP and AOC were measured in three groups: healthy volunteers, critically ill patients, and critically ill patients receiving 2- or 10-g vitamin C infusion. Its association was analyzed using regression models and by assessment of concordance. We measured 211 samples obtained from 103 subjects. Vitamin C concentrations were negatively associated with sORP ( = 0.816) and positively associated with AOC ( = 0.842). A high concordance of 94-100% was found between vitamin C concentration and sORP/AOC. Thus, plasma vitamin C concentrations are strongly associated with plasma sORP and AOC, as measured with a novel point-of-care device. Therefore, measuring sORP and AOC at the bedside has the potential to identify and monitor patients with oxidative stress and vitamin C deficiency.
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