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Research article
Effect of Vitamin C on mortality of critically ill patients with severe pneumonia in intensive care unit: A preliminary study
seied hadi saghaleini
Tabriz University of Medical Sciences
Corresponding Author
ORCiD: https://orcid.org/0000-0003-4996-4372
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This work is licensed under a CC BY 4.0 License. Read Full License
Background: Critically ill patients frequently suffer from vitamin C deficiency. Previous studies showed that high doses of vitamin C administration had conflicting results on clinical outcomes in patients with severe sepsis, burns and trauma. Because of the high incidence and morbidity/mortality with severe pneumonia, we aimed to investigate the effect of administration of high dose vitamin C in critically ill patients with severe pneumonia.
Methods: Eighty critically ill patients with pneumonia were enrolled in this randomized double blinded clinical trial. Patients with CURB-65 score >3, one major criteria, or ≥3 minor criteria were considered as severe pneumonia. Patients were randomly assigned to intervention or placebo groups receiving standard treatment plus 60 mg/kg/day vitamin C as continuous infusion or normal saline in the same volume correspondingly for 96 hours. Serum levels of vitamin C were noted at baseline and 48 hours after vitamin C administration. Duration of mechanical ventilation, ICU length of stay, PaO 2 /FiO 2 and mortality rate were noted for all patients till the 28 th day. Any complications related to the vitamin C administration were recorded. (IRCT registration number: IRCT20190312043030N1 , Registration date: 2019-08-26 , seied hadi saghaleini).
Results: Duration of mechanical ventilation and vasopressor use were significantly lower in intervention group ( p : <0.001 and 0.003, respectively). Baseline levels of vitamin C in both groups did not have significant difference but its levels increased in intervention group and decreased in control group during the study period. Mortality rate insignificantly decreased in intervention group ( p : 0.17). Three patients showed hypotension and tachycardia during the administration of vitamin C which was self-limited with decreasing the dose of vitamin C.
Conclusion: Our results showed that the intravenous administration of a relatively high dose of vitamin C to critically ill patients with severe pneumonia was safe and could decrease the inflammation, duration of mechanical ventilation and vasopressor use without any significant effect on mortality ( P value: 0.17).
Keywords
Vitamin C, pneumonia, mortality, critically ill
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CURRENT STATUS: Under Review
Version 3
Posted 21 Jan, 2021
No community comments so far
Editorial decision: Major revision
On 21 Feb, 2021
Review #1 received
Received 11 Feb, 2021
Reviewer #1 agreed
On 20 Jan, 2021
Reviewers invited
Invitations sent on 19 Jan, 2021
Editor assigned
On 10 Jan, 2021
Editor invited
On 10 Jan, 2021
Submission checks complete
On 10 Jan, 2021
No comments provided
Editorial decision: Major revision
On 29 Dec, 2020
Review #2 received
Received 30 Nov, 2020
Review #1 received
Received 08 Nov, 2020
Reviewer #2 agreed
On 29 Oct, 2020
Reviewer #1 agreed
On 19 Oct, 2020
Reviewers invited
Invitations sent on 28 Aug, 2020
Editor assigned
On 26 Aug, 2020
Submission checks complete
On 25 Aug, 2020
Editor invited
On 25 Aug, 2020
No comments provided
Editorial decision: Minor revision
On 23 Aug, 2020
Editor assigned
On 10 Aug, 2020
Submission checks complete
On 07 Aug, 2020
Editor invited
On 05 Aug, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Infectious Diseases
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This preprint is under consideration at BMC Infectious Diseases. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Effect of Vitamin C on mortality of critically ill patients with severe pneumonia in intensive care unit: A preliminary study
seied hadi saghaleini
Tabriz University of Medical Sciences
Corresponding Author
ORCiD: https://orcid.org/0000-0003-4996-4372
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 3
Posted 21 Jan, 2021
No community comments so far
Editorial decision: Major revision
On 21 Feb, 2021
Review #1 received
Received 11 Feb, 2021
Reviewer #1 agreed
On 20 Jan, 2021
Reviewers invited
Invitations sent on 19 Jan, 2021
Editor assigned
On 10 Jan, 2021
Editor invited
On 10 Jan, 2021
Submission checks complete
On 10 Jan, 2021
No comments provided
Editorial decision: Major revision
On 29 Dec, 2020
Review #2 received
Received 30 Nov, 2020
Review #1 received
Received 08 Nov, 2020
Reviewer #2 agreed
On 29 Oct, 2020
Reviewer #1 agreed
On 19 Oct, 2020
Reviewers invited
Invitations sent on 28 Aug, 2020
Editor assigned
On 26 Aug, 2020
Submission checks complete
On 25 Aug, 2020
Editor invited
On 25 Aug, 2020
No comments provided
Editorial decision: Minor revision
On 23 Aug, 2020
Editor assigned
On 10 Aug, 2020
Submission checks complete
On 07 Aug, 2020
Editor invited
On 05 Aug, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Infectious Diseases
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Critically ill patients frequently suffer from vitamin C deficiency. Previous studies showed that high doses of vitamin C administration had conflicting results on clinical outcomes in patients with severe sepsis, burns and trauma. Because of the high incidence and morbidity/mortality with severe pneumonia, we aimed to investigate the effect of administration of high dose vitamin C in critically ill patients with severe pneumonia.
Methods: Eighty critically ill patients with pneumonia were enrolled in this randomized double blinded clinical trial. Patients with CURB-65 score >3, one major criteria, or ≥3 minor criteria were considered as severe pneumonia. Patients were randomly assigned to intervention or placebo groups receiving standard treatment plus 60 mg/kg/day vitamin C as continuous infusion or normal saline in the same volume correspondingly for 96 hours. Serum levels of vitamin C were noted at baseline and 48 hours after vitamin C administration. Duration of mechanical ventilation, ICU length of stay, PaO 2 /FiO 2 and mortality rate were noted for all patients till the 28 th day. Any complications related to the vitamin C administration were recorded. (IRCT registration number: IRCT20190312043030N1 , Registration date: 2019-08-26 , seied hadi saghaleini).
Results: Duration of mechanical ventilation and vasopressor use were significantly lower in intervention group ( p : <0.001 and 0.003, respectively). Baseline levels of vitamin C in both groups did not have significant difference but its levels increased in intervention group and decreased in control group during the study period. Mortality rate insignificantly decreased in intervention group ( p : 0.17). Three patients showed hypotension and tachycardia during the administration of vitamin C which was self-limited with decreasing the dose of vitamin C.
Conclusion: Our results showed that the intravenous administration of a relatively high dose of vitamin C to critically ill patients with severe pneumonia was safe and could decrease the inflammation, duration of mechanical ventilation and vasopressor use without any significant effect on mortality ( P value: 0.17).
Figure 1