الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Ventilator-associated pneumonia (VAP) is a leading cause morbidity and mortality in intensive care unit (ICU) patients, several countries have reported mortality rates ranging from 24% to 76% and as a result prevention of VAP has become a focus of patient safety initiatives. Severely injured patients requiring admission to the intensive care unit (ICU) suffer from oxidative stress where hypo-perfusion, endothelial injury, and systemic activation of the immune response result in (or worsen) their critical illness, The underlying pathophysiology of oxidative stress is cytokines release and systemic inflammation triggered by reactive oxygen and nitrogen-oxygen sepsis, which leads to mitochondrial dysfunction, tissue injury, organ failure, and death. In the last two decades several clinical trials have evaluated the role of antioxidants micronutrients as a monotherapy or in combined therapy (enteral or parenteral antioxidant cocktails) as part of an antioxidant strategy for critically ill systemic inflammation response syndrome (SIRS) patients, for example, vitamin C is a strong antioxidant and has been shown to regenerate other antioxidants such as vitamin E, Vitamin C also play an important role in immune function. This study was carried out in Tanta University Hospitals at surgical intensive care unit (SICU) for one year between July 2016 to July 2017. A written informed consent was obtained from the patient’s guardians, 60 patients of (GCS ≤ 8), aged from (18-65 years) of both sex admitted to SICU were enrolled in the study. This study was designed as a prospective randomized controlledblind study. Sixty patients were included in our study and were randomly classified using closed sealed envelope into 2 equal groups each group consist of 30 patients according to sample size calculation. The aim of this study was evaluation of the effectiveness of early routine administration of intravenous high-dose vitamin C on the clinical outcomes in mechanically ventilated patients e.g. ventilator associated pneumonia rates, mortality rate, duration of mechanical ventilation, ICU length of stay, and hospital length of stay. Our result showed high dose of vitamin C for 7 days had a significant reduction in ventilator associated pneumonia, duration of mechanical ventilation, ICU length of stay and hospital length of stay but there was no significant reduction in mortality.