• J. Cardiothorac. Vasc. Anesth. · Feb 2020

    A Pilot, Double-Blind, Randomized, Controlled Trial of High-Dose Intravenous Vitamin C for Vasoplegia After Cardiac Surgery.

    • Fumitaka Yanase, Laurent Bitker, Lara Hessels, Eduardo Osawa, Thummaporn Naorungroj, Salvatore L Cutuli, Paul J Young, Jay Ritzema, Georgia Hill, Charlotte Latimer-Bell, Anna Hunt, Glenn M Eastwood, Andrew Hilton, and Rinaldo Bellomo.
    • Department of Intensive Care, Austin Hospital, Melbourne, Australia; Australian and New Zealand Intensive Care Research Centre, Monash University School of Public Health and Preventive Medicine, Melbourne, Australia.
    • J. Cardiothorac. Vasc. Anesth. 2020 Feb 1; 34 (2): 409-416.

    ObjectiveTo conduct a pilot feasibility and physiologic efficacy study of high-dose vitamin C in patients with vasoplegia after cardiac surgery.DesignProspective, double-blind, randomized, controlled trial.SettingTwo tertiary intensive care units (ICUs).ParticipantsPost-cardiac surgery patients with vasoplegia.InterventionsThe authors randomly assigned the patients to receive either high-dose intravenous vitamin C (1,500 mg every 6 hours) or placebo. The primary outcome was time from randomization to resolution of vasoplegia. Secondary outcomes included total norepinephrine equivalent dose in the first 2 days, ICU length of stay, ICU mortality, and in-hospital mortality.Measurements And Main ResultsThe authors studied 50 patients (25 patients in each arms). The mean (standard deviation) time to resolution of vasoplegia was 27.0 (16.5) hours in the vitamin C group versus 34.7 (41.1) hours in the placebo group (mean decrease with vitamin C of 7.7 hours, 95% confidence interval -10.5 to 25.9, p = 0.40). The median (interquartile range) norepinephrine equivalent dose in the first 2 days was 64.9 (23.5-236.5) µg/kg versus 47.4 (21.4-265.9) µg/kg in the vitamin C and placebo group (p = 0.75). The median duration of ICU admission was similar (1.4 [0.5-2.5] days and 1.5 [0.5-3.3] days in the vitamin C and placebo group; p = 0.36). Only 1 patient, in the vitamin C arm, died.ConclusionIn patients with post-cardiac surgery vasoplegia, high-dose vitamin C infusion was feasible, appeared safe, and, within the limitations of a pilot study, did not achieve statistically faster resolution of vasoplegia.Copyright © 2019 Elsevier Inc. All rights reserved.

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