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Title: A Pilot, Double-Blind, Randomized, Controlled Trial of High-Dose Intravenous Vitamin C for Vasoplegia After Cardiac Surgery.
Austin Authors: Yanase, Fumitaka ;Bitker, Laurent;Hessels, Lara;Osawa, Eduardo;Naorungroj, Thummaporn ;Cutuli, Salvatore L ;Young, Paul J;Ritzema, Jay;Hill, Georgia;Latimer-Bell, Charlotte;Hunt, Anna;Eastwood, Glenn M ;Hilton, Andrew K ;Bellomo, Rinaldo 
Affiliation: Service de médecine intensive et réanimation, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France
Centre for Integrated Critical Care, Department of Medicine & Radiology, University of Melbourne, Melbourne, Australia
Department of Intensive Care, Siriraj Hospital, Mahidol University, Bangkok, Thailand
Department of Critical Care, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
Department of Intensive Care, Austin Health, Heidelberg, Victoria, Australia
Australian and New Zealand Intensive Care Research Centre, Monash University School of Public Health and Preventive Medicine, Melbourne, Australia
Department of Intensive Care, Wellington Hospital, Wellington, New Zealand
Issue Date: Feb-2020
Date: 2019-08-24
Publication information: Journal of Cardiothoracic and Vascular Anesthesia 2020; 34(2): 409-416
Abstract: To conduct a pilot feasibility and physiologic efficacy study of high-dose vitamin C in patients with vasoplegia after cardiac surgery. Prospective, double-blind, randomized, controlled trial. Two tertiary intensive care units (ICUs). Post-cardiac surgery patients with vasoplegia. The 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. The 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. In 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.
DOI: 10.1053/j.jvca.2019.08.034
ORCID: 0000-0002-1650-8939
Journal: Journal of Cardiothoracic and Vascular Anesthesia
PubMed URL: 31526557
Type: Journal Article
Subjects: cardiopulmonary bypass
post-cardiac surgery
postoperative care
vitamin C
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