Vitamin C Critical Care
Randomized Controlled Trial
doi: 10.1186/s12879-021-06288-0.
Effect of Vitamin C on mortality of critically ill patients with severe pneumonia in intensive care unit: a preliminary study
Affiliations
- PMID: 34187382
- PMCID: PMC8240083
- DOI: 10.1186/s12879-021-06288-0
Free PMC article
Randomized Controlled Trial
Effect of Vitamin C on mortality of critically ill patients with severe pneumonia in intensive care unit: a preliminary study
Ata Mahmoodpoor et al. BMC Infect Dis. .
Free PMC article
Abstract
Background: Critically ill patients frequently suffer from vitamin C deficiency. Previous studies showed that high doses of vitamin C administration had conflicting results on clinical outcomes in patients with severe sepsis, burns, and trauma. Because of the high incidence and morbidity/mortality with severe pneumonia, we aimed to investigate the effect of administration of high dose vitamin C in critically ill patients with severe pneumonia.
Methods: Eighty critically ill patients with pneumonia were enrolled in this randomized double-blinded clinical trial. Patients with a CURB-65 score > 3, one major criterion, or ≥ 3 minor criteria were considered as severe pneumonia. Patients were randomly assigned to intervention or placebo groups receiving standard treatment plus 60 mg/kg/day vitamin C as a continuous infusion or normal saline in the same volume correspondingly for 96 h. Serum levels of vitamin C were noted at baseline and 48 h after vitamin C administration. Duration of mechanical ventilation, ICU length of stay, PaO2/FiO2, and mortality rate were noted for all patients till the 28th day. Any complications related to the vitamin C administration were recorded.
Results: Duration of mechanical ventilation and vasopressor use were significantly lower in the intervention group (p: < 0.001 and 0.003, respectively). Baseline levels of vitamin C in both groups did not have a significant difference but its levels increased in the intervention group and decreased in the control group during the study period. Mortality rate insignificantly decreased in the intervention group (p = 0.17). Three patients showed hypotension and tachycardia during the administration of vitamin C which was self-limited with decreasing the dose of vitamin C. Our results showed that the intravenous administration of a relatively high dose of vitamin C to critically ill patients with severe pneumonia was safe and could decrease the inflammation, duration of mechanical ventilation, and vasopressor use without any significant effect on mortality.
Trial registration: IRCT registration number: IRCT20190312043030N1, Registration date: 2019-08-26, Seied Hadi Saghaleini.
Keywords: Critically ill; Mortality; Pneumonia; Vitamin C.
Conflict of interest statement
All authors declare no conflict of interest.
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References
-
- Padayatty SJ, Levine M. Vitamin C: the known and the unknown and goldilocks. Oral Dis. 2016;22(6):463–493. doi: 10.1111/odi.12446. - DOI - PMC - PubMed
-
- Carr AC, Rosengrave PC, Bayer S, Chambers S, Mehrtens J, Shaw GM. Hypovitaminosis C and vitamin C defciency in critically ill patients despite recommended enteral and parenteral intakes. Crit Care. 2017;21(1):300. doi: 10.1186/s13054-017-1891-y. - DOI - PMC - PubMed
-
- Marik PE. Hydrocortisone, Ascorbic Acid and Thiamine (HAT Therapy) for the Treatment of Sepsis. Focus on Ascorbic Acid. Nutrients. 2018;10(11):1762–77. 10.3390/nu10111762. - PMC - PubMed
-
- Fujii T, Luethi N, Young PJ, Frei DR, Eastwood GE, French CJ, et al. Effect of Vitamin C, Hydrocortisone, and Thiamine vs Hydrocortisone alone on time alive and free of vasopressor support among patients with Septic shock. The VITAMINS randomized clinical trial. JAMA. 2020;323(5):423–431. doi: 10.1001/jama.2019.22176. - DOI - PMC - PubMed
-
- Corkovic L, Begovic D, Milosevic D, Miloskovic V, Obradovic M, Jelic S, et al. serum vitamin C level in patients with acute pneumonia and in COPD patients before and after therapy. Chest. 2006;130:184s. doi: 10.1378/chest.130.4_MeetingAbstracts.184S-b. - DOI
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