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: |
05 Dec 2022 15:35 |
PubMed ID: |
31778629 |
URI: |
https://boris.unibe.ch/id/eprint/138510 |
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