Pharmacokinetic data support 6-hourly dosing of intravenous vitamin C to critically ill patients with septic shock.

Hudson, Elizabeth P; Collie, Jake Tb; Fujii, Tomoko; Luethi, Nora; Udy, Andrew A; Doherty, Sarah; Eastwood, Glenn; Yanase, Fumitaka; Naorungroj, Thummaporn; Bitker, Laurent; Abdelhamid, Yasmine Ali; Greaves, Ronda F; Deane, Adam M; Bellomo, Rinaldo (2019). Pharmacokinetic data support 6-hourly dosing of intravenous vitamin C to critically ill patients with septic shock. Critical care and resuscitation, 21(4), pp. 236-242. College of Intensive Care Medicine of Australia and New Zealand

Full text not available from this repository. (Request a copy)

OBJECTIVES

To study vitamin C pharmacokinetics in septic shock.

DESIGN

Prospective pharmacokinetic study.

SETTING

Two intensive care units.

PARTICIPANTS

Twenty-one patients with septic shock enrolled in a randomised trial of high dose vitamin C therapy in septic shock.

INTERVENTION

Patients received 1.5 g intravenous vitamin C every 6 hours. Plasma samples were obtained before and at 1, 4 and 6 hours after drug administration, and vitamin C concentrations were measured by high performance liquid chromatography.

MAIN OUTCOME MEASURES

Clearance, volume of distribution, and half-life were calculated using noncompartmental analysis. Data are presented as median (interquartile range [IQR]).

RESULTS

Of the 11 participants who had plasma collected before any intravenous vitamin C administration, two (18%) were deficient (concentrations < 11 μmol/L) and three (27%) had hypovitaminosis C (concentrations between 11 and 23 μmol/L), with a median concentration 28 μmol/L (IQR, 11-44 μmol/L). Volume of distribution was 23.3 L (IQR, 21.9-27.8 L), clearance 5.2 L/h (IQR, 3.3-5.4 L/h), and half-life 4.3 h (IQR, 2.6-7.5 h). For the participants who had received at least one dose of intravenous vitamin C before sampling, T0 concentration was 258 μmol/L (IQR, 162- 301 μmol/L). Pharmacokinetic parameters for subsequent doses were a median volume of distribution 39.9 L (IQR, 31.4-44.4 L), clearance 3.6 L/h (IQR, 2.6-6.5 L/h), and half-life 6.9 h (IQR, 5.7-8.5 h).

CONCLUSION

Intravenous vitamin C (1.5 g every 6 hours) corrects vitamin C deficiency and hypovitaminosis C and provides an appropriate dosing schedule to achieve and maintain normal or elevated vitamin C levels in septic shock.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Medical Oncology

UniBE Contributor:

Lüthi, Nora

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1441-2772

Publisher:

College of Intensive Care Medicine of Australia and New Zealand

Language:

English

Submitter:

Rebeka Gerber

Date Deposited:

22 Jan 2020 08:07

Last Modified:

22 Jan 2020 08:07

PubMed ID:

31778629

URI:

https://boris.unibe.ch/id/eprint/138510

Actions (login required)

Edit item Edit item
Provide Feedback