The effect of vitamin C supplementation additive to the priming solution on postoperative bleeding in coronary artery bypass grafting: A randomized controlled trial

Patients undergoing cardiac surgery often experience bleeding during and after the procedure. Antioxidants such as Vitamin C (VC) are used to manage postoperative bleeding and inflammation after cardiac surgery.

A total of 110 patients undergoing elective coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB) were enrolled. Patients were randomly assigned into two groups of 55 participants each. In the intervention group, 25 mg/kg of VC was added to the CPB priming solution. In the control group, 25 mg/kg of normal saline was added instead. Nurse recorded the amount of chest tube drainage on intensive care unit (ICU) entry, and 2, 4, 6, 12, and 24 hours. They also documented the amount of blood product transfusion required during surgery and in the ICU.

The amount of chest tube drainage in the control group was higher than the intervention group, but this difference was not statistically significant between the two groups (P > 0.05). The amount transfused blood in the operating room and in the ICU in the intervention group was 1.64±0.79 and 2.14±1.17 ml, respectively, and in the control group it was 1.69±0.84 and 2.52±1.68 ml, which was not statistically significant between the two groups (P > 0.05). There was no significant difference in duration of ICU and hospital stay between the two groups (P > 0.05).

Adding VC to the CPB prime showed a non-significant trend toward reduced postoperative bleeding after CABG. Current evidence from this study is insufficient to recommend routine use; further larger trials are needed.