PDF(Pubmed)
Abstract：
Ascorbic acid, or vitamin C, is a physiological antioxidant that has been found to be deficient in critically ill adults with sepsis and acute respiratory distress system. In adults, ascorbic acid supplementation has been shown to reduce the need for vasopressors and mechanical ventilation. This study aimed to describe the prevalence of ascorbic acid deficiency in critically ill pediatric patients. This prospective, single-centered study analyzed 34 patients aged 1 month to 18 years old with septic shock and/or acute respiratory failure requiring mechanical ventilation in a quaternary, urban, pediatric intensive care unit. Plasma ascorbic acid levels were measured by high-performance liquid chromatography within 24 hours of meeting eligibility criteria. The median level was 23.34 µM (IQR [11.45, 39.14]). Twenty-three patients had repeat samples that were collected 3 to 5 days later. The median for repeat samples was higher at 42.41 µM (IQR [13.08, 62.43]). Patients who were enterally fed had significantly higher levels than those who were not (62.4 ± 7.7 µM vs. 32.4 ± 7.1 µM; p = 0.03). Ascorbic acid levels vary widely among critically ill children with septic shock and/or respiratory failure requiring mechanical ventilation, but one-half of our patients had deficient levels that are typically seen in scurvy. Further studies are warranted to investigate the significance of low levels as well as the impact of normalizing levels through nutritional support.
摘要：
抗坏血酸,或者维生素C,是一种生理抗氧化剂，已发现在患有败血症和急性呼吸窘迫系统的重症成人中缺乏。在成年人中,补充抗坏血酸已被证明可以减少对血管加压药和机械通气的需求。这项研究旨在描述危重患儿中抗坏血酸缺乏的患病率。这个未来,单中心研究分析了34例1个月至18岁的感染性休克和/或急性呼吸衰竭患者，需要四元机械通气，城市,儿科重症监护室.在满足合格标准的24小时内通过高效液相色谱法测量血浆抗坏血酸水平。中位数水平为23.34µM（IQR[11.45,39.14]）。23名患者具有3至5天后收集的重复样品。重复样品的中位数更高，为42.41µM（IQR[13.08,62.43]）。接受肠内喂养的患者的水平明显高于未接受肠内喂养的患者（62.4±7.7µMvs.32.4±7.1µM；p=0.03）。在需要机械通气的感染性休克和/或呼吸衰竭的危重患儿中，抗坏血酸水平差异很大。但是我们有一半的患者有典型的镰刀病缺乏水平。需要进一步的研究来调查低水平的重要性以及通过营养支持使水平正常化的影响。
