Am College of Surgeons: High-Dose Antioxidants Improve Trauma Outcomes By John Gever, Staff Writer, MedPage Today Reviewed by Zalman S. Agus, MD; Emeritus Professor University of Pennsylvania School of Medicine. Infections and abdominal wall complications were markedly reduced in trauma patients treated with high doses of vitamins C, E, and selenium, researchers said here. Rates of abdominal compartment syndrome, pulmonary failure, and surgical site infections were significantly reduced when trauma center patients received a one-week course of the antioxidants beginning at admission, reported Bryan A. Cotton, M.D., of Vanderbilt University in Nashville, and colleagues. Their study, presented at the American College of Surgeons' Clinical Congress, was a retrospective review comparing results for 2,272 patients admitted to the Vanderbilt trauma center from October 2005 through September 2006, when the antioxidant treatment was given routinely to incoming patients, with results for 2,022 patients admitted the previous year, when no antioxidants were given. The antioxidant regimen consisted of 1,000 mg of vitamin C and 1,000 IU of alpha-tocopherol three times a day and 200 mcg/day of intravenous selenium. The treatment was not given to pregnant patients or those with serum creatinine higher than 2.5 mg/dL. Rates of complications in the treatment group versus controls included: Abdominal compartment syndrome: 0.7% versus 2.9%, P<0.001 Respiratory failure: 17.4% versus 27.6%, P<0.001 Overall infections: 12.3% versus 15.0%, P=0.014 Surgical site infection: 1.3% versus 2.7%, P=0.002 The researchers calculated an odds ratio of 0.62 (95% CI 0.53 to 0.74) for respiratory failure after the antioxidant protocol was instituted compared with the earlier period. For abdominal wall complications, the odds ratio with antioxidant treatment was 0.47 (95% CI 0.33 to 0.67). There were no significant differences for other complications, including ventilator-associated pneumonia, systemic inflammatory response syndrome, septic shock, renal failure, wound dehiscence, or sacral decubiti. Patient demographics and injury severity were similar in the two periods, the researchers found. About 15% to 20% of the Vanderbilt trauma center's caseload involves penetrating wounds. Dr. Cotton and colleagues had previously reported mortality data from the same study, in which death rates were reduced significantly to 6.1% from 8.5% before the protocol was implemented (P=0.001). It also appears that the sickest patients get the greatest benefit from the treatment, Dr. Cotton added. Those with less serious illness no longer receive the antioxidants at Vanderbilt. The researchers now have studies of dosing and duration of treatment underway to determine if outcomes can be improved further. Dr. Cotton noted that the current week-long treatment costs $11 per patient. The research had no external funding. The authors reported no potential conflicts of interest. Primary source: Journal of the American College of Surgeons Source reference: Giladi A, et al "Treatment of acutely injured patients with high-dose anti-oxidants is associated with a significant reduction in pulmonary failure, catheter-related infections, and abdominal wall complications" J Am College Surgeons 2008; 207: S40-S41. Published: October 17, 2008 Thanks to www.medpagetoday.com Remember we are NOT Doctors and have NO medical training. This site is like an Encylopedia - there are many pages, many links on many topics. Support our work with any size DONATION - see left side of any page - for how to donate. You can help raise awareness of CAM.