Effect of Vitamin C on mortality of critically ill patients with severe pneumonia in intensive care unit: a preliminary study

BackgroundCritically 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.MethodsEighty 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 60mg/kg/day vitamin C as a continuous infusion or normal saline in the same volume correspondingly for 96h. Serum levels of vitamin C were noted at baseline and 48h after vitamin C administration. Duration of mechanical ventilation, ICU length of stay, PaO2/FiO(2), and mortality rate were noted for all patients till the 28th day. Any complications related to the vitamin C administration were recorded.ResultsDuration 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.

Automated summary

This study examined the effects of high-dose intravenous vitamin C administration on critically ill patients with severe pneumonia. The results showed that it was safe and could reduce inflammation, duration of mechanical ventilation, and vasopressor use, with no significant effect on mortality.