Intravenous vitamin C for vasoplegia: A double-blinded randomised clinical trial (VALENCIA trial)

Abstract

PurposeTo determine whether intravenous vitamin C compared with placebo, reduces vasopressor requirements in patients with vasoplegic shock. MethodsDouble-blinded, randomised clinical trial (RCT) conducted in two intensive care units in Perth, Australia. Vasopressor requirements at enrolment needed to be >10 μg/min noradrenaline after hypovolaemia was clinically excluded. Patients received either intravenous 1.5 g sodium ascorbate in 100 ml normal saline every 6 h for 5 days, or placebo (100 ml normal saline). The primary outcome was duration of vasopressor usage in hours. Secondary outcomes were ICU and hospital length of stay, and 28-day, ICU and hospital mortality. ResultsOf the 71 patients randomised (35 vitamin C, 36 placebo group), the median vasopressor duration was 44 h [95% CI, 37–54 h] and 55 h [95% CI, 33–66 h]) in the vitamin C and placebo groups (p = 0.057). ICU and hospital length of stay, mortality outcomes were similar between groups. ConclusionsIn this RCT of patients with vasoplegic shock of at least moderate severity, the use of IV vitamin C compared with placebo did not significantly reduce the duration of vasopressors. Trial registrationProspective registration – trial number ACTRN12617001392358.