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Title:Vpliv vitamina c na biološke označevalce okvare možganov pri bolnikih s povratkom spontanega krvnega obtoka po zunajbolnišničnem srčnem zastoju
Authors:ID Privšek, Matevž (Author)
ID Markota, Andrej (Mentor) More about this mentor... New window
ID Strnad, Matej (Comentor)
Files:.pdf DOK_Privsek_Matevz_2025.pdf (1,52 MB)
MD5: 17A55A3D20FE50C9CE56C2AA2AF107B8
 
Language:Slovenian
Work type:Dissertation
Typology:2.08 - Doctoral Dissertation
Organization:MF - Faculty of Medicine
Abstract:Preživetje z ugodnim nevrološkim izidom po zunajbolnišničnem srčnem zastoju (OHCA) ostaja izziv in je pogosto poslabšano zaradi poreanimacijskega sindroma (PCAS), ki obsega okvaro možganov in srca. Ta raziskava je preučila vpliv intravenskega dodajanja vitamina C, antioksidanta, za ublažitev PCAS, saj lahko izčrpane zaloge vitamina C pri kritično bolnih prispevajo k oksidativnemu stresu, ki je eden od mehanizmov PCAS. Izvedli smo randomizirano, dvojno slepo raziskavo na odraslih preživelih po OHCA v terciarni bolnišnici. Udeleženci so prejeli 1,5 g vitamina C intravensko vsakih 12 ur v osmih odmerkih ali placebo, kot dodatek standardni oskrbi. Okvara možganov je bila primarno ocenjena s koncentracijo nevronsko-specifične enolaze (NSE), skupaj z drugimi kliničnimi izidi. Rezultati so pokazali statistično neznačilno višjo koncentracijo NSE v skupini z vitaminom C (36,4 µg/L, placebo 34,9 µg/L, p > 0,05) in večjo pojavnost mioklonusa. Hkrati pa so imeli bolniki, ki so prejemali vitamin C, manj aritmij, srčnega popuščanja, manjšo potrebo po vazoaktivnih zdravilih, krajši čas zdravljenja in statistično značilno manjši porast vnetnih kazalcev (p = 0,02). Zaključek: Raziskava je pokazala, da intravensko dodajanje vitamina C pri bolnikih po zunajbolnišničnem srčnem zastoju ni pomembno zmanjšalo okvare možganov, je pa prispevalo k izboljšanju vnetnih kazalcev in nekaterih srčnih izidov. Potrebne so nadaljnje raziskave za razjasnitev njegove potencialne vloge v poreanimacijski oskrbi.
Keywords:vitamin C, nevronsko-specifična enolaza, zunajbolnišnični srčni zastoj, povratek spontanega krvnega obtoka, preživetje
Place of publishing:Maribor
Publisher:[M. Privšek]
Year of publishing:2025
PID:20.500.12556/DKUM-90695 New window
UDC:577.164.2/.334:616.831-005+616.12-008.315(043.3)
COBISS.SI-ID:229143555 New window
Publication date in DKUM:19.03.2025
Views:241
Downloads:68
Metadata:XML DC-XML DC-RDF
Categories:MF
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Licences

License:CC BY-NC-ND 4.0, Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International
Link:http://creativecommons.org/licenses/by-nc-nd/4.0/
Description:The most restrictive Creative Commons license. This only allows people to download and share the work for no commercial gain and for no other purposes.
Licensing start date:16.09.2024

Secondary language

Language:English
Title:Impact of vitamin C on biomarkers of brain injury in patients with return of spontaneous circulation after out-of-hospital cardiac arrest
Abstract:Survival with favorable neurological outcomes after out-of-hospital cardiac arrest (OHCA) remains challenging and is often complicated by post-cardiac arrest syndrome (PCAS), which involves brain and heart damage. This study examined the effect of intravenous vitamin C (VitC), an antioxidant, in mitigating PCAS, as vitamin C depletion in critically ill patients may contribute to oxidative stress, one of the mechanisms of PCAS. We conducted randomized, double-blind study included adult OHCA survivors at a tertiary hospital. Participants received either 1.5 g of intravenous VitC every 12 hours for eight doses or placebo in addition to the standard care. Neurological injury was primarily assessed by neuron-specific enolase (NSE) levels, alongside other clinical outcomes. Results showed non-significantly higher NSE levels in the VitC group (36.4 µg/L vs. 34.9 µg/L, p > 0.05) and a higher incidence of myoclonus. However, the VitC group had fewer arrhythmias, less heart failure, less need for vasoactive drugs, shorter intensive care unit stay, and a significantly smaller increase in inflammatory markers (p = 0.02). Conclusion: The study demonstrated that intravenous administration of vitamin C in patients after OHCA did not significantly reduce brain injury but contributed to the improvement of inflammatory markers and some cardiac outcomes. Further research is needed to clarify its potential role in post-resuscitation care.
Keywords:vitamin C, neuron-specific enolase, out-of-hospital cardiac arrest, return of spontaneous circulation, survival


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