Evaluation of Ascorbic Acid Adjuvant Therapy and Oxidative Stress Parameters in Burns Patients

Abstract

Background: Burns trauma is associated with considerable morbidity and mortality. Resuscitation of burns patients with high-dose of Ascorbic acid has shown potential for mitigating the injury, but the optimal dose for this indication is unknown. Aim: This study aimed to evaluate the impact of adjuvant therapy with intravenous Ascorbic acid (6g over 24 hours) on indicators of oxidative stress in patients with major burns. Materials and Methods: We conducted a randomized placebo-controlled study on patients with major burns who presented at the National Orthopaedic Hospital, Enugu, Nigeria between August 2017 and July 2020. Each patient in the treatment group received intravenous Ascorbic acid, 6g over 24 hours, while those in the placebo group received Normal saline in the resuscitation fluid. Oxidative stress evaluation was based on measurement of total antioxidant capacity and malondialdehyde in the participants. The level of statistical significance was determined by a p value of <0.05. Results: The study was conducted on 37 burns patients and 15 healthy subjects. At presentation, the burns patients had significantly lower total antioxidant capacity; P=0.006, and higher serum malondialdehyde; P=0.040, compared to the healthy volunteers. The decrease in serum malondialdehyde in the burns patients treated with high-dose Ascorbic acid; 0.9±0.8 nmol/mL, was greater than that in those treated with placebo; 0.3±1.4 nmol/mL. Similarly the increase in total antioxidant capacity in the burns patients treated with high-dose Ascorbic acid; 151.7±116.5 µmol/L was greater than that in those treated with placebo; 58.4±219.1 µmol/L. However these effects weren’t statistically significant. Conclusion: Intravenous Ascorbic acid at a dose of 6g over 24 hours did not significantly alter the indicators of oxidative stress in the burns patients, under the prevailing conditions of the study.