Abstract

Cardiothoracic surgery, particularly when involving extracorporeal circulation, is associated with a systemic inflammatory response and oxidative stress resulting from the ischemia-reperfusion phenomenon. This phenomenon leads to the release of free radicals, causing cellular damage, activation of pro-inflammatory signaling pathways, and depletion of endogenous antioxidants. These processes contribute to various perioperative complications, including postoperative atrial fibrillation, pulmonary complications and endothelial dysfunction. Due to its antioxidant properties, vitamin C has been proposed to exert a protective effect against these adverse responses and to potentially enhance postoperative recovery.

This narrative review aims to evaluate the role of vitamin C in cardiothoracic surgery and to examine its potential benefits with regard postoperative atrial fibrillation, fatigue, etomidate-induced adrenergic inhibition, cardiac allograft vasculopathy, postoperative pulmonary complications, endothelial function, vasoplegia, acute renal failure, biochemical markers and erythrocytes integrity.

The only outcomes with consistent evidence of benefit from vitamin C supplementation were a reduction in the incidence of postoperative atrial fibrillation, an improvement in endothelial function and a reduction in oxidative stress. Further large-scale, multicenter randomized controlled trials are warranted to establish the optimal dosage, timing of administration and specific patient populations that may derive the greatest benefit from vitamin C administration.