ascorbic-acid and Shock--Traumatic

Fluid resuscitation to maintain adequate tissue perfusion while reducing edema in the severely burned patient remains a challenge. Recent studies suggest that reactive oxygen species generated by thermal injury are involved in edema formation associated with burn. The present study tested the hypothesis that adding a free radical scavenger to the resuscitation fluid would reduce total fluid requirements in the treatment of severe thermal injury. Anesthetized chronically instrumented sheep received a 40% total body surface area full-thickness flame burn. At 1 h after injury, animals were resuscitated with lactated Ringer's (LR, n = 14) as control, LR containing high doses of vitamin C (VC, n = 6), 1000 mOsM hypertonic saline (HS, n = 7), or 1000 HS containing VC (HS/VC, n = 7) in coded bags so that investigators were blinded to the treatment. Fluids were infused at an initial Parkland rate of 10 mL/kg/h, adjusted hourly to restore and maintain urine output at 1 to 2 mL/kg/h. Sheep in the VC or HS/VC group received 250 mg/kg VC in the first 500 mL of LR or HS, and then 15 mg/kg/h thereafter. Hemodynamic variables and indices of antioxidant status were measured. At 48 h postburn, sheep were euthanized, and heart, liver, lung, skeletal muscle, and ileum were evaluated for antioxidant status. All fluid resuscitation regimens were equally effective in restoring cardiac output to near baseline levels; no treatment effects were apparent on arterial pressure or heart rate. VC infusion significantly reduced fluid requirements and, therefore, net fluid balance (fluid in, urine out) by about 30% at 6 h and about 50% at 48 h in comparison with the LR group (P < 0.05). HS and HS/VC reduced fluid requirements by 30% and 65%, respectively, at 6 h, but the volume-sparing effect of HS was not observed after 36 h and that of HS/VC was lost after 12 h. Plasma total antioxidant potential increased about 25-fold (P < 0.05) at 2 and 3 h in response to VC infusion compared with the LR and HS groups, and remained about 5- to 10-fold higher throughout the rest of the study. VC infusion also prevented the 4-fold increase in plasma thiobarbituric acid reactive substances seen in the LR group early after burn (P < 0.05). Tissue antioxidant status was similar between groups. In this sheep burn model, continuous high-dose VC infusion reduced net fluid balance, reduced indices of plasma lipid peroxidation, and maintained overall antioxidant status in comparison with standard-of-care LR

Topics: Animals; Antioxidants; Arteries; Ascorbic Acid; Burns; Edema; Female; Fluid Therapy; Free Radical Scavengers; Hematocrit; Hemodynamics; Lipid Peroxidation; Resuscitation; Saline Solution, Hypertonic; Sheep; Shock, Traumatic; Sodium Chloride; Thiobarbituric Acid Reactive Substances; Time Factors; Tissue Distribution

The blood of healthy men and patients with methemoglobinemia of different genesis was incubated with chromosmon, ascorbic acid, riboflavin and glutathione, the percentage of erythrocytes with thorn-shaped protuberances-echinocytes being subsequently determined in the blood smears. The absorbtion spectra at the range 400-650 nm were investigated both in the smooth erythrocytes and in echinocytes. A correlation was found between the percentage of echinocytes and the methemoglobin content in the blood. The methemoglobin amount in the echinocytes was determined to be higher than in the smooth erythrocytes. It is discovered that effects of chromosmon, glutathione and riboflavin on production of methemoglobin depend on the dose, individual peculiarities of erythrocytes and on the illness that caused methemoglobinemia. The calculation of echinocyte percentage may be used as an express-diagnostics of methemoglobinemia and for purposes of studying the effect of methemoglobin-producing substances and drugs.

Topics: Ascorbic Acid; Bronchitis; Chronic Disease; Dose-Response Relationship, Drug; Erythrocytes; Glutathione; Hemoglobins; Humans; Methemoglobin; Methemoglobinemia; Methylene Blue; Pulmonary Heart Disease; Riboflavin; Sepsis; Shock, Traumatic; Spectrophotometry

Topics: Acute Kidney Injury; Adrenal Glands; Adrenocorticotropic Hormone; Animals; Ascorbic Acid; Crush Syndrome; Hypothalamus; Male; Pituitary Gland; Rats; Shock, Traumatic; Time Factors

Topics: Aged; Aging; Arteriosclerosis; Ascorbic Acid; Ascorbic Acid Deficiency; Back Pain; Common Cold; Humans; Mental Disorders; Nutritional Requirements; Pituitary-Adrenal System; Renal Dialysis; Shock, Traumatic; Stress, Physiological; Structure-Activity Relationship; Surgical Procedures, Operative

Topics: 17-Hydroxycorticosteroids; Adrenal Glands; Alkaline Phosphatase; Animals; Ascorbic Acid; Burns; Cholesterol; Histocytochemistry; Hyperplasia; Lipid Metabolism; Organ Size; Rabbits; Shock, Traumatic

Topics: Animals; Ascorbic Acid; Dogs; Humans; Infusions, Parenteral; Shock; Shock, Surgical; Shock, Traumatic; Vitamin B Complex

Topics: Ascorbic Acid; Convulsive Therapy; Shock, Traumatic; Vitamins