Austin Health

Title
Vitamin C measurement in critical illness: challenges, methodologies and quality improvements.
Publication Date
2020-03-26
Author(s)
Collie, Jake T B
Greaves, Ronda F
Jones, Oliver A H
Eastwood, Glenn M
Bellomo, Rinaldo
Subject
ascorbic acid
critically ill
intensive care
measurement
vitamin C
Type of document
Journal Article
OrcId
0000-0001-7823-8797
0000-0002-1650-8939
DOI
10.1515/cclm-2019-0912
Abstract
Background There is renewed interest in high-dose vitamin C interventions in clinical medicine due to its antioxidant properties, safe use and cost-effectiveness. Yet, randomised control trials (RCTs) employing these interventions are failing to include robust analytical methodology and proper sample handling and processing techniques. Consequently, comparisons between studies becomes impossible as there is no metrological traceability and results may be prone to pre-analytical errors. Content Through published vitamin C stability studies, method comparison papers and data from vitamin C external quality assurance programs, an assessment was made on the functionality of current methods for critically ill patient samples. Summary Data was obtained from two external quality assurance programs, two papers assessing sample stability and interlaboratory agreement and a publication on vitamin C method comparisons. A shift from spectrophotometric and enzymatic methodologies to high performance liquid chromatography (HPLC) greatly improved the variability and interlaboratory agreement. Therefore, the current analytical performance of vitamin C HPLC methodologies are acceptable for the requirements of a high-dose vitamin C RCTs. Outlook Recommendations across the total testing process of vitamin C have been provided to improve the quality of the results. The harmonisation of sample handling and processing procedures will further improve the reliability of current analytical methodologies.
Link
Citation
Clinical Chemistry and Laboratory Medicine 2020; 58(4): 460-470
Jornal Title
Clinical Chemistry and Laboratory Medicine

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