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Title: A Pilot, Double-Blind, Randomized, Controlled Trial of High-Dose Intravenous Vitamin C for Vasoplegia After Cardiac Surgery
Authors: 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
Rinaldo Bellomo
University of Melbourne
Wellington Hospital, New Zealand
Monash University
Faculty of Medicine, Siriraj Hospital, Mahidol University
Hopital de la Croix-Rousse
University of Groningen, University Medical Center Groningen
Austin Hospital
Keywords: Medicine
Issue Date: 1-Feb-2020
Citation: Journal of Cardiothoracic and Vascular Anesthesia. Vol.34, No.2 (2020), 409-416
Abstract: © 2019 Elsevier Inc. Objective: To conduct a pilot feasibility and physiologic efficacy study of high-dose vitamin C in patients with vasoplegia after cardiac surgery. Design: Prospective, double-blind, randomized, controlled trial. Setting: Two tertiary intensive care units (ICUs). Participants: Post-cardiac surgery patients with vasoplegia. Interventions: 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. Measurements and Main Results: 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. Conclusion: 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.
ISSN: 15328422
Appears in Collections:Scopus 2020

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