Details

Autor(en) / Beteiligte

• Fowler, 3rd, Alpha A
• Truwit, Jonathon D
• Hite, R Duncan
• Morris, Peter E
• DeWilde, Christine
• Priday, Anna
• Fisher, Bernard
• Thacker, 2nd, Leroy R
• Natarajan, Ramesh
• Brophy, Donald F
• Sculthorpe, Robin
• Nanchal, Rahul
• Syed, Aamer
• Sturgill, Jamie
• Martin, Greg S
• Sevransky, Jonathan
• Kashiouris, Markos
• Hamman, Stella
• Egan, Katherine F
• Hastings, Andrei
• Spencer, Wendy
• Tench, Shawnda
• Mehkri, Omar
• Bindas, James
• Duggal, Abhijit
• Graf, Jeanette
• Zellner, Stephanie
• Yanny, Lynda
• McPolin, Catherine
• Hollrith, Tonya
• Kramer, David
• Ojielo, Charles
• Damm, Tessa
• Cassity, Evan
• Wieliczko, Aleksandra
• Halquist, Matthew

Titel

Effect of Vitamin C Infusion on Organ Failure and Biomarkers of Inflammation and Vascular Injury in Patients With Sepsis and Severe Acute Respiratory Failure: The CITRIS-ALI Randomized Clinical Trial

Ist Teil von

• JAMA : the journal of the American Medical Association, 2019-10, Vol.322 (13), p.1261

Ort / Verlag

United States

Erscheinungsjahr

2019

Quelle

MEDLINE

Beschreibungen/Notizen

• Experimental data suggest that intravenous vitamin C may attenuate inflammation and vascular injury associated with sepsis and acute respiratory distress syndrome (ARDS). To determine the effect of intravenous vitamin C infusion on organ failure scores and biological markers of inflammation and vascular injury in patients with sepsis and ARDS. The CITRIS-ALI trial was a randomized, double-blind, placebo-controlled, multicenter trial conducted in 7 medical intensive care units in the United States, enrolling patients (N = 167) with sepsis and ARDS present for less than 24 hours. The study was conducted from September 2014 to November 2017, and final follow-up was January 2018. Patients were randomly assigned to receive intravenous infusion of vitamin C (50 mg/kg in dextrose 5% in water, n = 84) or placebo (dextrose 5% in water only, n = 83) every 6 hours for 96 hours. The primary outcomes were change in organ failure as assessed by a modified Sequential Organ Failure Assessment score (range, 0-20, with higher scores indicating more dysfunction) from baseline to 96 hours, and plasma biomarkers of inflammation (C-reactive protein levels) and vascular injury (thrombomodulin levels) measured at 0, 48, 96, and 168 hours. Among 167 randomized patients (mean [SD] age, 54.8 years [16.7]; 90 men [54%]), 103 (62%) completed the study to day 60. There were no significant differences between the vitamin C and placebo groups in the primary end points of change in mean modified Sequential Organ Failure Assessment score from baseline to 96 hours (from 9.8 to 6.8 in the vitamin C group [3 points] and from 10.3 to 6.8 in the placebo group [3.5 points]; difference, -0.10; 95% CI, -1.23 to 1.03; P = .86) or in C-reactive protein levels (54.1 vs 46.1 μg/mL; difference, 7.94 μg/mL; 95% CI, -8.2 to 24.11; P = .33) and thrombomodulin levels (14.5 vs 13.8 ng/mL; difference, 0.69 ng/mL; 95% CI, -2.8 to 4.2; P = .70) at 168 hours. In this preliminary study of patients with sepsis and ARDS, a 96-hour infusion of vitamin C compared with placebo did not significantly improve organ dysfunction scores or alter markers of inflammation and vascular injury. Further research is needed to evaluate the potential role of vitamin C for other outcomes in sepsis and ARDS. ClinicalTrials.gov Identifier: NCT02106975.