Document Type : Original Article


1 Department of Clinical Pharmacy, Tehran University of Medical Sciences, Tehran, Iran

2 Department of Intensive Care Unit, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran


Objective: Effects of ascorbic acid on hemodynamic parameters of septic shock were 
evaluated in nonsurgical critically ill patients in limited previous studies. In this study, 
the effect of high‑dose ascorbic acid on vasopressor drug requirement was evaluated 
in surgical critically ill patients with septic shock.
Methods: Patients with septic shock who required a vasopressor drug to maintain mean 
arterial pressure >65 mmHg were assigned to receive either 25 mg/kg intravenous 
ascorbic acid every 6 h or matching placebo for 72 h. Vasopressor dose and duration 
were considered as the primary outcomes. Duration of Intensive Care Unit (ICU) stay 
and 28‑day mortality has been defined as secondary outcomes.
Findings: During the study period, 28patients(14 in each group) completed the trial. Mean 
dose of norepinephrine during the study period (7.44 ± 3.65 vs. 13.79 ± 6.48 mcg/min,
P=0.004) and duration of norepinephrine administration(49.64±25.67vs. 71.57±1.60h,
P = 0.007) were significantly lower in the ascorbic acid than the placebo group. No 
statistically significant difference was detected between the groups regarding the length 
of ICU stay. However, 28‑day mortality was significantly lower in the ascorbic acid than 
the placebo group (14.28% vs. 64.28%, respectively; P = 0.009).
Conclusion: High‑dose ascorbic acid may be considered as an effective and safe adjuvant 
therapy in surgical critically ill patients with septic shock. The most effective dose of 
ascorbic acid and the best time for its administration should be determined in future 


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