TY  - JOUR
A1  - Dresen, Ellen
A1  - Pimiento, Jose M.
A1  - Patel, Jayshil J.
A1  - Heyland, Daren K.
A1  - Rice, Todd W.
A1  - Stoppe, Christian
T1  - Overview of oxidative stress and the role of micronutrients in critical illness
JF  - Journal of Parenteral and Enteral Nutrition
N2  - Inflammation and oxidative stress represent physiological response mechanisms to different types of stimuli and injury during critical illness. Its proper regulation is fundamental to cellular and organismal survival and are paramount to outcomes and recovery from critical illness. A proper maintenance of the delicate balance between inflammation, oxidative stress, and immune response is crucial for resolution from critical illness with important implications for patient outcome. The extent of inflammation and oxidative stress under normal conditions is limited by the antioxidant defense system of the human body, whereas the antioxidant capacity is commonly significantly compromised, and serum levels of micronutrients and vitamins significantly depleted in patients who are critically ill. Hence, the provision of antioxidants and anti-inflammatory nutrients may help to reduce the extent of oxidative stress and therefore improve clinical outcomes in patients who are critically ill. As existing evidence of the beneficial effects of antioxidant supplementation in patients who are critically ill is still unclear, actual findings about the most promising anti-inflammatory and antioxidative candidates selenium, vitamin C, zinc, and vitamin D will be discussed in this narrative review. The existing evidence provided so far demonstrates that several factors need to be considered to determine the efficacy of an antioxidant supplementation strategy in patients who are critically ill and indicates the need for adequately designed multicenter prospective randomized control trials to evaluate the clinical significance of different types and doses of micronutrients and vitamins in selected groups of patients with different types of critical illness.
KW  - critical illness
KW  - vitamins
KW  - vitamin C
KW  - inflammation
KW  - medical nutrition therapy
KW  - oxidative stress
KW  - selenium
KW  - trace elements
KW  - micronutrients
KW  - vitamin D
KW  - zinc
Y1  - 2023
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-318186
VL  - 47
SP  - S38
EP  - S49
ER  - 
TY  - JOUR
A1  - Dresen, Ellen
A1  - Lee, Zheng-Yii
A1  - Hill, Aileen
A1  - Notz, Quirin
A1  - Patel, Jayshil J.
A1  - Stoppe, Christian
T1  - History of scurvy and use of vitamin C in critical illness: A narrative review
JF  - Nutrition in Clinical Practice
N2  - In 1747, an important milestone in the history of clinical research was set, as the Scottish surgeon James Lind conducted the first randomized controlled trial. Lind was interested in scurvy, a severe vitamin C deficiency which caused the death of thousands of British seamen. He found that a dietary intervention with oranges and lemons, which are rich in vitamin C by nature, was effective to recover from scurvy. Because of its antioxidative properties and involvement in many biochemical processes, the essential micronutrient vitamin C plays a key role in the human biology. Moreover, the use of vitamin C in critical illness—a condition also resulting in death of thousands in the 21st century—has gained increasing interest, as it may restore vascular responsiveness to vasoactive agents, ameliorate microcirculatory blood flow, preserve endothelial barriers, augment bacterial defense, and prevent apoptosis. Because of its redox potential and powerful antioxidant capacity, vitamin C represents an inexpensive and safe antioxidant, with the potential to modify the inflammatory cascade and improve clinical outcomes of critically ill patients. This narrative review aims to update and provide an overview on the role of vitamin C in the human biology and in critically ill patients, and to summarize current evidence on the use of vitamin C in diverse populations of critically ill patients, in specific focusing on patients with sepsis and coronavirus disease 2019.
KW  - antioxidant
KW  - scurvy
KW  - sepsis
KW  - vitamin C
KW  - critical illness
KW  - COVID‐19
Y1  - 2023
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-318176
VL  - 38
IS  - 1
SP  - 46
EP  - 54
ER  -