Document Type : Original Article
Authors
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
Abstract
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
studies.
Keywords
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