High Dose Vitamin C Improves Inflammatory Markers and Clinical Outcome Of Patients With Acute Respiratory Distress Syndrome

Abstract

Objectives: To evaluate the clinical outcome, efficacy and tolerability of high dose IV Vitamin C administration in acute respiratory distress syndrome patients. Patients and Methods: A prospective, randomized, controlled, open-label study conducted at ICU of the National Center for Allergy and Chest Diseases, Cairo, Egypt. Forty clinically and radiologically diagnosed cases of eligible ARDS patients were randomized to either, Group 1 (Control;20); received conventional ARDS management, or Group 2 (Test;20); received 10 g IV Vitamin C on two divided doses, both for 10 days. 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 from study start. Results: Both 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 the test versus the 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 was comparable across 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. High dose vitamin C reduced IL8 levels and facilitated weaning off MV. Vitamin C was tolerable with no significant side effects or drug interactions reported throughout the 10 days-treatment.

Keywords

• vitamin c
• ards
• nrf2
• il8
• mechanical ventilation