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Fluids & Electrolytes
A high-dose antioxidant regimen may help prevent infections, pulmonary failure, and abdominal-wall compartment syndrome in trauma patients. Researchers assessed outcomes for 4,279 patients admitted to a trauma unit over a 1-year period. About half of the patients were admitted before and half after a protocol of administering high doses of antioxidants was implemented. The protocol included treatment with vitamin C (1,000 mg) and vitamin E (1,000 international units) every 8 hours, by mouth if tolerated. Patients also received I.V. infusions of selenium (200 micrograms) every day. Treatment began upon arrival and continued for 7 days or until discharge, whichever came first. Pregnant women and patients with serum creatinine levels greater than 2.5 mg/dL were excluded from the protocol.
Antioxidant therapy was associated with significant reductions in complications: abdominal-wall compartment syndrome (31 cases among patients with the protocol vs. 90 cases without), catheter-related infections (50 vs. 75), surgical site infections (44 vs. 101), and pulmonary failure (528 vs. 721). No differences in the incidence of pneumonia or renal failure occurred between the two groups.
The findings were presented at the 2008 Clinical Congress of the American College of Surgeons.
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