Vitamin C measurement in critical illness: challenges, methodologies and quality improvements
- 5 December 2019
- journal article
- review article
- Published by Walter de Gruyter GmbH in cclm
- Vol. 58 (4), 460-470
- https://doi.org/10.1515/cclm-2019-0912
Abstract
Background There is renewed interest in high-dose vitamin C interventions in clinical medicine due to its antioxidant properties, safe use and cost-effectiveness. Yet, randomised control trials (RCTs) employing these interventions are failing to include robust analytical methodology and proper sample handling and processing techniques. Consequently, comparisons between studies becomes impossible as there is no metrological traceability and results may be prone to pre-analytical errors. Content Through published vitamin C stability studies, method comparison papers and data from vitamin C external quality assurance programs, an assessment was made on the functionality of current methods for critically ill patient samples. Summary Data was obtained from two external quality assurance programs, two papers assessing sample stability and interlaboratory agreement and a publication on vitamin C method comparisons. A shift from spectrophotometric and enzymatic methodologies to high performance liquid chromatography (HPLC) greatly improved the variability and interlaboratory agreement. Therefore, the current analytical performance of vitamin C HPLC methodologies are acceptable for the requirements of a high-dose vitamin C RCTs. Outlook Recommendations across the total testing process of vitamin C have been provided to improve the quality of the results. The harmonisation of sample handling and processing procedures will further improve the reliability of current analytical methodologies.Keywords
This publication has 79 references indexed in Scilit:
- Human skeletal muscle ascorbate is highly responsive to changes in vitamin C intake and plasma concentrationsThe American Journal of Clinical Nutrition, 2013
- Quantificação sérica de vitamina C por CLAE-UV e estudo de estabilidadeQuímica Nova, 2012
- Antioxidant Therapy Reduces Oxidative and Inflammatory Tissue Damage in Patients Subjected to Cardiac Surgery with Extracorporeal CirculationBasic & Clinical Pharmacology & Toxicology, 2010
- Vitamins E and C in the Prevention of Cardiovascular Disease in MenJAMA, 2008
- Influence of early antioxidant supplements on clinical evolution and organ function in critically ill cardiac surgery, major trauma, and subarachnoid hemorrhage patientsCritical Care, 2008
- Oral Vitamin C Administration Increases Lipid Peroxidation in Hemodialysis PatientsNephron Clinical Practice, 2007
- Depletion of plasma antioxidants in surgical intensive care unit patients requiring parenteral feeding: effects of parenteral nutrition with or without alanyl-glutamine dipeptide supplementationNutrition, 2007
- Experimental Vitamin C Depletion and Supplementation in Young MenAnnals of the New York Academy of Sciences, 1987
- Measurement of Vitamin C in Blood Components by High‐Performance Liquid ChromatographyAnnals of the New York Academy of Sciences, 1987
- Vitamin C Deficiency in an Otherwise Normal AdultNew England Journal of Medicine, 1940