High Dose Vitamin C Improves Inflammatory Markers and Clinical Outcome
of Patients with Acute Respiratory Distress Syndrome
Abstract
Objectives: To assess the efficacy, tolerability and clinical outcome of
high dose IV Vitamin C administration in patients with Acute respiratory
distress syndrome (ARDS). Design: A prospective, randomized, controlled,
open-label study. Setting: Intensive Care Unit of Embaba-Chest Hospital,
Cairo, Egypt. Patients: Forty clinically and radiologically diagnosed
cases of eligible ARDS patients were randomized to either, Group 1
(Control); 20 patients received conventional ARDS management, or Group 2
(Test); 20 ARDS patients received IV Vitamin C 10 g on two divided
doses, both for 10 days. Interventions: Vitamin C, Interleukin 8 (IL8)
and nuclear factor erythroid 2–related factor 2 (NRf2) levels together
with PaO2/FiO2 were all measured for both groups at baseline and after
10 days. Main Results: Groups were comparable at baseline. After 10 days
of Vitamin C administration, a significant increase (P<0.001)
in levels of Vitamin C, NRf2 and PaO2/FiO2 together with a significant
decrease (P<0.001) in IL8 was noted in test versus control
group. Number of patients weaned off mechanical ventilation MV was
significantly higher in test versus control groups (15 versus 6,
p=0.004, respectively). Survival and occurrence of side effects were
comparable between groups. Conclusions: Administration of 10 g IV
Vitamin C in 2 divided doses daily for 10 days in ARDS patients improved
lung functions, pulmonary oxygenation, oxidative stress and inflammatory
markers and weaning off MV and reduced IL8 levels. Vitamin C was
tolerable with no significant side effects or drug interactions reported
throughout the 10 days-treatment. (Clinicaltrials.gov Registration
number: NCT03780933)