High-dose intravenous vitamin C reduce C-reactive protein levels, fluid retention, and APACHE II scores in patients with moderately severe acute pancreatitis: a prospective, randomized, double-blinded, placebo-controlled study
Abstract Background The aim of this study was to investigate whether high-dose intravenous vitamin C (HDIVC) could decrease the mortality rate within 28 days among patients moderately severe acute pancreatitis (MSAP) and severe acute pancreatitis (SAP). Methods In this randomized, placebo-controlled...
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SpringerOpen
2025-03-01
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| Series: | Annals of Intensive Care |
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| Online Access: | https://doi.org/10.1186/s13613-025-01437-z |
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| author | Bing Zhao Wenwu Sun Yihui Wang Li Ma Menglu Gui Jiaoyan Li Xianxian Yu Xing Qi Ning Ning Silei Sun Mengjiao Li Yi Yao Tongtian Ni Juan He Zhitao Yang Ying Chen Huiqiu Sheng Meihua Shen Jian Li Jun Huang Enqiang Mao |
| author_facet | Bing Zhao Wenwu Sun Yihui Wang Li Ma Menglu Gui Jiaoyan Li Xianxian Yu Xing Qi Ning Ning Silei Sun Mengjiao Li Yi Yao Tongtian Ni Juan He Zhitao Yang Ying Chen Huiqiu Sheng Meihua Shen Jian Li Jun Huang Enqiang Mao |
| author_sort | Bing Zhao |
| collection | DOAJ |
| description | Abstract Background The aim of this study was to investigate whether high-dose intravenous vitamin C (HDIVC) could decrease the mortality rate within 28 days among patients moderately severe acute pancreatitis (MSAP) and severe acute pancreatitis (SAP). Methods In this randomized, placebo-controlled trial, patients diagnosed with predicted MSAP or SAP within 72 h of symptom onset were enrolled to receive either a vitamin C infusion (200 mg/kg/24 h) or a matched placebo for 7 days. The primary outcome was 28-day mortality. Results 212 adults including 155 MSAP and 57 SAP were enrolled from September 2019 to June 2023. The trial was terminated prematurely due to a lower than expected 28-day mortality rate which showed no difference between the HDIVC and Control group (3/109 vs. 4/103, unadjusted OR: 0.70, 95% CI, 0.15–3.21, p = 0.647). Among patients with MSAP, the HDIVC group exhibited a more pronounced reduction in C-reactive protein levels compared to the Control group (Day0 to Day3, median 72 mg/L vs. 46 mg/L, p = 0.003; Day0 to Day7, median 168 mg/L vs. 121 mg/L, p = 0.013); The volume of fluid retention was lower in the HDIVC group compared to the Control group (Day0-Day1, median 676.5 ml vs. 1130 ml, P = 0.04; Day0-Day2, median 511 ml vs. 1290 ml, P = 0.02; Day0-Day3, median 692 ml vs. 1534 ml, P = 0.04). The APACHE II scores reduction from Day0 to Day7 was significantly greater in the HDIVC group in APACHE II scores (median change of 3 vs. 2, P = 0.01). No significant difference was observed among patients with SAP. Conclusion HDIVC did not significantly reduce 28-day mortality in MSAP and SAP patients. While it showed potential benefits in reducing CRP, fluid retention, and APACHE II scores in MSAP patients, these effects may not be directly related to the study drug, and no similar changes were observed in SAP patients. Trial registration ChiCTR.org.cn, ChiCTR1900022022. Registered March 21 2019, https//www.chictr.org.cn/showproj.html?proj=37,106 . |
| format | Article |
| id | doaj-art-6ac5a0b9b6934ec398ecc6036d9bf4be |
| institution | DOAJ |
| issn | 2110-5820 |
| language | English |
| publishDate | 2025-03-01 |
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| series | Annals of Intensive Care |
| spelling | doaj-art-6ac5a0b9b6934ec398ecc6036d9bf4be2025-08-20T02:52:19ZengSpringerOpenAnnals of Intensive Care2110-58202025-03-0115111310.1186/s13613-025-01437-zHigh-dose intravenous vitamin C reduce C-reactive protein levels, fluid retention, and APACHE II scores in patients with moderately severe acute pancreatitis: a prospective, randomized, double-blinded, placebo-controlled studyBing Zhao0Wenwu Sun1Yihui Wang2Li Ma3Menglu Gui4Jiaoyan Li5Xianxian Yu6Xing Qi7Ning Ning8Silei Sun9Mengjiao Li10Yi Yao11Tongtian Ni12Juan He13Zhitao Yang14Ying Chen15Huiqiu Sheng16Meihua Shen17Jian Li18Jun Huang19Enqiang Mao20Department of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Pharmacy, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineNational Center for Translational Medicine (Shanghai) SHU Branch, Shanghai UniversityClinical Research Center, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Cardiovascular Medicine, State Key Laboratory of Medical Genomics, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineAbstract Background The aim of this study was to investigate whether high-dose intravenous vitamin C (HDIVC) could decrease the mortality rate within 28 days among patients moderately severe acute pancreatitis (MSAP) and severe acute pancreatitis (SAP). Methods In this randomized, placebo-controlled trial, patients diagnosed with predicted MSAP or SAP within 72 h of symptom onset were enrolled to receive either a vitamin C infusion (200 mg/kg/24 h) or a matched placebo for 7 days. The primary outcome was 28-day mortality. Results 212 adults including 155 MSAP and 57 SAP were enrolled from September 2019 to June 2023. The trial was terminated prematurely due to a lower than expected 28-day mortality rate which showed no difference between the HDIVC and Control group (3/109 vs. 4/103, unadjusted OR: 0.70, 95% CI, 0.15–3.21, p = 0.647). Among patients with MSAP, the HDIVC group exhibited a more pronounced reduction in C-reactive protein levels compared to the Control group (Day0 to Day3, median 72 mg/L vs. 46 mg/L, p = 0.003; Day0 to Day7, median 168 mg/L vs. 121 mg/L, p = 0.013); The volume of fluid retention was lower in the HDIVC group compared to the Control group (Day0-Day1, median 676.5 ml vs. 1130 ml, P = 0.04; Day0-Day2, median 511 ml vs. 1290 ml, P = 0.02; Day0-Day3, median 692 ml vs. 1534 ml, P = 0.04). The APACHE II scores reduction from Day0 to Day7 was significantly greater in the HDIVC group in APACHE II scores (median change of 3 vs. 2, P = 0.01). No significant difference was observed among patients with SAP. Conclusion HDIVC did not significantly reduce 28-day mortality in MSAP and SAP patients. While it showed potential benefits in reducing CRP, fluid retention, and APACHE II scores in MSAP patients, these effects may not be directly related to the study drug, and no similar changes were observed in SAP patients. Trial registration ChiCTR.org.cn, ChiCTR1900022022. Registered March 21 2019, https//www.chictr.org.cn/showproj.html?proj=37,106 .https://doi.org/10.1186/s13613-025-01437-zSevere acute pancreatitisVitamin CRandomized controlled trialMortalityC-reactive proteinFluid retention |
| spellingShingle | Bing Zhao Wenwu Sun Yihui Wang Li Ma Menglu Gui Jiaoyan Li Xianxian Yu Xing Qi Ning Ning Silei Sun Mengjiao Li Yi Yao Tongtian Ni Juan He Zhitao Yang Ying Chen Huiqiu Sheng Meihua Shen Jian Li Jun Huang Enqiang Mao High-dose intravenous vitamin C reduce C-reactive protein levels, fluid retention, and APACHE II scores in patients with moderately severe acute pancreatitis: a prospective, randomized, double-blinded, placebo-controlled study Annals of Intensive Care Severe acute pancreatitis Vitamin C Randomized controlled trial Mortality C-reactive protein Fluid retention |
| title | High-dose intravenous vitamin C reduce C-reactive protein levels, fluid retention, and APACHE II scores in patients with moderately severe acute pancreatitis: a prospective, randomized, double-blinded, placebo-controlled study |
| title_full | High-dose intravenous vitamin C reduce C-reactive protein levels, fluid retention, and APACHE II scores in patients with moderately severe acute pancreatitis: a prospective, randomized, double-blinded, placebo-controlled study |
| title_fullStr | High-dose intravenous vitamin C reduce C-reactive protein levels, fluid retention, and APACHE II scores in patients with moderately severe acute pancreatitis: a prospective, randomized, double-blinded, placebo-controlled study |
| title_full_unstemmed | High-dose intravenous vitamin C reduce C-reactive protein levels, fluid retention, and APACHE II scores in patients with moderately severe acute pancreatitis: a prospective, randomized, double-blinded, placebo-controlled study |
| title_short | High-dose intravenous vitamin C reduce C-reactive protein levels, fluid retention, and APACHE II scores in patients with moderately severe acute pancreatitis: a prospective, randomized, double-blinded, placebo-controlled study |
| title_sort | high dose intravenous vitamin c reduce c reactive protein levels fluid retention and apache ii scores in patients with moderately severe acute pancreatitis a prospective randomized double blinded placebo controlled study |
| topic | Severe acute pancreatitis Vitamin C Randomized controlled trial Mortality C-reactive protein Fluid retention |
| url | https://doi.org/10.1186/s13613-025-01437-z |
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