Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/22119
Title: Pharmacokinetic data support 6-hourly dosing of intravenous vitamin C to critically ill patients with septic shock.
Austin Authors: Hudson, Elizabeth P;Collie, Jake TB;Fujii, Tomoko;Luethi, Nora;Udy, Andrew A;Doherty, Sarah;Eastwood, Glenn;Yanase, Fumitaka ;Naorungroj, Thummaporn ;Bitker, Laurent;Abdelhamid, Yasmine Ali;Greaves, Ronda F;Deane, Adam M;Bellomo, Rinaldo 
Affiliation: Melbourne Medical School, University of Melbourne, Melbourne, VIC, Australia
School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, Australia
Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia
Intensive Care Unit, Royal Melbourne Hospital, Melbourne, VIC, Australia
Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia
Department of Intensive Care, Austin Health, Heidelberg, Victoria, Australia
Melbourne Medical School, University of Melbourne, Melbourne, VIC, Australia
School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, Australia
Melbourne Medical School, University of Melbourne, Melbourne, VIC, Australia
Issue Date: Dec-2019
Publication information: Critical Care and Resuscitation 2019; 21(4): 236-42
Abstract: To study vitamin C pharmacokinetics in septic shock. Prospective pharmacokinetic study. Two intensive care units. Twenty-one patients with septic shock enrolled in a randomised trial of high dose vitamin C therapy in septic shock. Patients received 1.5 g intravenous vitamin C every 6 hours. Plasma samples were obtained before and at 1, 4 and 6 hours after drug administration, and vitamin C concentrations were measured by high performance liquid chromatography. Clearance, volume of distribution, and half-life were calculated using noncompartmental analysis. Data are presented as median (interquartile range [IQR]). Of the 11 participants who had plasma collected before any intravenous vitamin C administration, two (18%) were deficient (concentrations < 11 μmol/L) and three (27%) had hypovitaminosis C (concentrations between 11 and 23 μmol/L), with a median concentration 28 μmol/L (IQR, 11-44 μmol/L). Volume of distribution was 23.3 L (IQR, 21.9-27.8 L), clearance 5.2 L/h (IQR, 3.3-5.4 L/h), and half-life 4.3 h (IQR, 2.6-7.5 h). For the participants who had received at least one dose of intravenous vitamin C before sampling, T0 concentration was 258 μmol/L (IQR, 162- 301 μmol/L). Pharmacokinetic parameters for subsequent doses were a median volume of distribution 39.9 L (IQR, 31.4-44.4 L), clearance 3.6 L/h (IQR, 2.6-6.5 L/h), and half-life 6.9 h (IQR, 5.7-8.5 h). Intravenous vitamin C (1.5 g every 6 hours) corrects vitamin C deficiency and hypovitaminosis C and provides an appropriate dosing schedule to achieve and maintain normal or elevated vitamin C levels in septic shock.
URI: http://ahro.austin.org.au/austinjspui/handle/1/22119
ORCID: 0000-0002-1650-8939
PubMed URL: 31778629
ISSN: 1441-2772
Type: Journal Article
Appears in Collections:Journal articles

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