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Antioxidants Vitamin E and Vitamin C for Nutritional Support in Critically Ill Patients: Beneficial or Harmful?

Sebastian Rehberg, MD, Marc O Maybauer, MD, PhD, Dirk M Maybauer, MD, Perenlei Enkhbaatar, MD, PhD, Maret G Traber, PhD, and Daniel L Traber, PhD

Morbidity and mortality of patients with critical illness are positively correlated with the degree of oxidative stress. Therefore, the administration of antioxidants such as vitamin C and vitamin E seems to be a reasonable therapeutic approach. However, there is conflicting evidence about antioxidant supplementation. Whereas experimental and observational studies suggest beneficial effects in critically ill patients, large, randomised, controlled, multicentre trials for the prevention of cardiovascular diseases and cancer, or for the treatment of chronic diseases, reveal contradicting results. It remains questionable whether patients suffering from acute critical disease or injury would respond similarly to antioxidant administration as healthy or chronically ill patients. This article briefly reviews the current literature on the role of vitamin C and vitamin E for antioxidative support in intensive care patients, and discusses potential beneficial and harmful effects of vitamin C and vitamin E supplementation in critical illness. Adv Anaesthesiol Crit Care 2009;1(1):11–19.

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