Une opération chirurgicale abaisse les niveaux de vitamines

[Nutrimuscle-Conseils]

The effects of surgery on plasma vitamin C concentrations and cognitive function: a protocol for a prospective, observational study
Nikolaj Travica, Nutrition and Health Vol. 27, No. 2, June 1, 2021

Background:
Post-operative cognitive function has recently become an area of focus for researchers. The most commonly reported perioperative neurocognitive disorders include delirium and longer-lasting post-operative cognitive dysfunctions. The contributing pathophysiology to these complications remains unclear. A number of studies have systematically revealed a significant post-operative plasma vitamin C depletion. Recent insights have also exhibited a link between plasma vitamin C and numerous biological roles in brain function, with deficiencies potentially compromising cognitive function.

Aim:
The present prospective, observational study will investigate whether there is a possible link between post-operative plasma vitamin C depletion and cognitive dysfunction.

Methods:
The cohort will consist of surgical patients, between the ages of 65 and 85 years, undergoing hip replacement surgery or a control group not exposed to surgical trauma. Participants will have their plasma vitamin C concentrations tested alongside a battery of computer-based cognitive assessments and paper and pen based cognitive tests. Further assessments will include dietary nutritional intake, serum vitamin B12 concentrations, cardiovascular biomarkers, wound healing, sleep quality, pain, mood and inflammatory cytokines. Participants will be tested at baseline (1–2 weeks prior to surgery) and subsequent testing sessions will be performed within 1 week, 4–6 weeks, 3 months and 6 months following surgery.

Conclusions:
Findings from this observational study will provide insight into whether there is a concomitant depletion in post-operative plasma vitamin C concentrations and cognition function. Extrapolated results may prompt future, extensive randomized controlled trials to assess whether vitamin C supplementation can alleviate or even prevent post-operative cognitive complications.

[Nutrimuscle-Diététique]

Traduction de l'étude

Les effets de la chirurgie sur les concentrations plasmatiques de vitamine C et la fonction cognitive: un protocole pour une étude observationnelle prospective
Nikolaj Travica, Nutrition et Santé Vol. 27, n ° 2, 1 juin 2021

Arrière-plan:
La fonction cognitive postopératoire est récemment devenue un domaine d'intérêt pour les chercheurs. Les troubles neurocognitifs périopératoires les plus fréquemment rapportés comprennent le délire et les dysfonctionnements cognitifs postopératoires de plus longue durée. La pathophysiologie contribuant à ces complications reste incertaine. Un certain nombre d'études ont systématiquement révélé une déplétion plasmatique significative en vitamine C postopératoire. Des informations récentes ont également montré un lien entre la vitamine C plasmatique et de nombreux rôles biologiques dans la fonction cérébrale, des carences pouvant compromettre la fonction cognitive.

Objectif:
La présente étude observationnelle prospective examinera s'il existe un lien possible entre l'épuisement postopératoire de la vitamine C plasmatique et le dysfonctionnement cognitif.

Méthodes:
La cohorte comprendra des patients chirurgicaux, âgés de 65 à 85 ans, subissant une arthroplastie de la hanche ou un groupe témoin non exposé à un traumatisme chirurgical. Les participants feront tester leurs concentrations plasmatiques de vitamine C ainsi qu'une batterie d'évaluations cognitives informatisées et de tests cognitifs sur papier et stylo. D'autres évaluations comprendront l'apport nutritionnel alimentaire, les concentrations sériques de vitamine B12, les biomarqueurs cardiovasculaires, la cicatrisation des plaies, la qualité du sommeil, la douleur, l'humeur et les cytokines inflammatoires. Les participants seront testés au départ (1 à 2 semaines avant la chirurgie) et les sessions de test suivantes seront effectuées dans les 1 semaine, 4 à 6 semaines, 3 mois et 6 mois après la chirurgie.

Conclusions:
Les résultats de cette étude observationnelle permettront de déterminer s'il existe une déplétion concomitante des concentrations plasmatiques de vitamine C postopératoires et de la fonction cognitive. Les résultats extrapolés peuvent inciter à de futurs essais contrôlés randomisés approfondis pour évaluer si la supplémentation en vitamine C peut atténuer ou même prévenir les complications cognitives postopératoires.

[Nutrimuscle-Conseils]

The effects of cardiovascular and orthopaedic surgery on vitamin concentrations: a narrative review of the literature and mechanisms of action
Nikolaj Travica Critical Reviews in Food Science and Nutrition 07 Oct 2021

Given the rise in worldwide chronic diseases, supplemented by an aging population, the volume of global major surgeries, encompassing cardiac and orthopedic procedures is anticipated to surge significantly. Surgical trauma can be accompanied by numerous postoperative complications and metabolic changes. The present review summarized the results from studies assessing the effects of orthopedic and cardiovascular surgery on vitamin concentrations, in addition to exploring the possible mechanisms associated with changes in concentrations.

Studies have revealed a potentially severe depletion in plasma/serum concentrations of numerous vitamins following these surgeries acutely. Vitamins C, D and B1 appear particularly vulnerable to significant depletions, with vitamin C and D depletions consistently transpiring into inadequate and deficient concentrations, respectively. The possible multifactorial mechanisms impacting postoperative vitamin concentrations include changes in hemodilution and vitamin utilization, redistribution, circulatory transport and absorption. For a majority of vitamins, there has been a lack of investigation into the effects of both, cardiac and orthopedic surgery. Additionally, studies were predominantly restricted to short-term postoperative investigations, primarily performed within the first postoperative week of surgery.

Overall, results indicated that further examination is necessary to determine the severity and clinical significance of the possible depletions in vitamin concentrations that ensue cardiovascular and orthopedic surgery.