Uso de ácido ascórbico en pacientes con traumatismo craneoencefálico severo y su impacto en el tiempo de estancia en la Unidad de Cuidados Intensivos adultos

Abstract

Introduction : Traumatic brain injury (TBI) is the leading cause of death and disability in young adults around the world. The secondary lesion develops with the release of oxygen free radicals. In addition to its powerful action as a free radical scavenger, ascorbic acid stabilizes the endothelium and promotes the integrity of the blood-brain barrier (BBB). Objective : To determine the usefulness of ascorbic acid in patients with severe TBI and its impact on the length of hospital stay in the Adult Intensive Care Unit (ICU). Material and methods : Randomized clinical trial, open in the ICU of the Centro Médico Nacional del Bajío UMAE No. 1, León, Guanajuato, Mexico, from April 2020 to July 2020. 24 patients (12 experimental group and 12 controls) were admitted by probabilistic sampling with Severe TBI in people over 18 years of age. Administration of ascorbic acid one gram every six hours intravenously. Ascorbic acid administration was correlated with length of stay in ICU and hospitalization, mortality and neurological scales. Analysis of SPSS version 21 results. Results : 24 patients were included, mean ages 26 and 49 years, experimental and control group respectively (p = 0.004). Average of the Glasgow Coma Scale at the time of admission was 7 and 6.7 points respectively (p = 0.378). Stay in the ICU with 7 and 3.71 days (p = 0.001), hospital stay 12.5 and 5.85 days respectively (p = 0.001). At discharge, the Glasgow scale resulted in 3.50 and 3.57 points respectively (p = 0.630). 28-day mortality of 1 and 3 cases respectively (p = 0.59); the survival analysis reflected higher survival for the experimental group (p = 0.010). Conclusion : The use of ascorbic acid in severe TBI had a negative impact on the ICU stay, as well as the length of hospitalization. Survival analysis showed lower mortality at 28 days for the experimental group compared to the control.