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Hypovitaminosis C and vitamin C deficiency in critically ill patients despite recommended enteral and parenteral intakes

Overview of attention for article published in Critical Care, December 2017
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (97th percentile)
  • High Attention Score compared to outputs of the same age and source (88th percentile)

Mentioned by

news
1 news outlet
blogs
4 blogs
twitter
87 tweeters
facebook
2 Facebook pages

Citations

dimensions_citation
161 Dimensions

Readers on

mendeley
240 Mendeley
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Title
Hypovitaminosis C and vitamin C deficiency in critically ill patients despite recommended enteral and parenteral intakes
Published in
Critical Care, December 2017
DOI 10.1186/s13054-017-1891-y
Pubmed ID
Authors

Anitra C. Carr, Patrice C. Rosengrave, Simone Bayer, Steve Chambers, Jan Mehrtens, Geoff M. Shaw

Abstract

Vitamin C is an essential water-soluble nutrient which cannot be synthesised or stored by humans. It is a potent antioxidant with anti-inflammatory and immune-supportive roles. Previous research has indicated that vitamin C levels are depleted in critically ill patients. In this study we have assessed plasma vitamin C concentrations in critically ill patients relative to infection status (septic shock or non-septic) and level of inflammation (C-reactive protein concentrations). Vitamin C status was also assessed relative to daily enteral and parenteral intakes to determine if standard intensive care unit (ICU) nutritional support is adequate to meet the vitamin C needs of critically ill patients. Forty-four critically ill patients (24 with septic shock, 17 non-septic, 3 uncategorised) were recruited from the Christchurch Hospital Intensive Care Unit. We measured concentrations of plasma vitamin C and a pro-inflammatory biomarker (C-reactive protein) daily over 4 days and calculated patients' daily vitamin C intake from the enteral or total parenteral nutrition they received. We compared plasma vitamin C and C-reactive protein concentrations between septic shock and non-septic patients over 4 days using a mixed effects statistical model, and we compared the vitamin C status of the critically ill patients with known vitamin C bioavailability data using a four-parameter log-logistic response model. Overall, the critically ill patients exhibited hypovitaminosis C (i.e., < 23 μmol/L), with a mean plasma vitamin C concentration of 17.8 ± 8.7 μmol/L; of these, one-third had vitamin C deficiency (i.e., < 11 μmol/L). Patients with hypovitaminosis C had elevated inflammation (C-reactive protein levels; P < 0.05). The patients with septic shock had lower vitamin C concentrations and higher C-reactive protein concentrations than the non-septic patients (P < 0.05). Nearly 40% of the septic shock patients were deficient in vitamin C, compared with 25% of the non-septic patients. These low vitamin C levels were apparent despite receiving recommended intakes via enteral and/or parenteral nutritional therapy (mean 125 mg/d). Critically ill patients have low vitamin C concentrations despite receiving standard ICU nutrition. Septic shock patients have significantly depleted vitamin C levels compared with non-septic patients, likely resulting from increased metabolism due to the enhanced inflammatory response observed in septic shock.

Twitter Demographics

The data shown below were collected from the profiles of 87 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 240 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 240 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 32 13%
Other 26 11%
Student > Master 26 11%
Student > Bachelor 22 9%
Student > Ph. D. Student 18 8%
Other 53 22%
Unknown 63 26%
Readers by discipline Count As %
Medicine and Dentistry 96 40%
Pharmacology, Toxicology and Pharmaceutical Science 21 9%
Nursing and Health Professions 17 7%
Biochemistry, Genetics and Molecular Biology 10 4%
Agricultural and Biological Sciences 9 4%
Other 16 7%
Unknown 71 30%

Attention Score in Context

This research output has an Altmetric Attention Score of 81. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 25 April 2021.
All research outputs
#348,891
of 19,191,572 outputs
Outputs from Critical Care
#232
of 5,571 outputs
Outputs of similar age
#11,758
of 427,934 outputs
Outputs of similar age from Critical Care
#26
of 216 outputs
Altmetric has tracked 19,191,572 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 98th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 5,571 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 17.4. This one has done particularly well, scoring higher than 95% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 427,934 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 97% of its contemporaries.
We're also able to compare this research output to 216 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 88% of its contemporaries.