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

To assess the efficacy, tolerability, and clinical outcome of high dose IV Vitamin C administration in patients suffering from acute respiratory distress syndrome (ARDS). A prospective, randomized, controlled, open-label study was conducted at the Intensive Care Unit 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 patients received conventional ARDS management, or Group 2 (Test); 20 ARDS patients 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. 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. The number of patients weaned off mechanical ventilation MV was significantly higher in the test versus the control groups (15 versus 6, P= 0.004, respectively). Survival and occurrence of side effects were comparable across groups. In conclusion, 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 daystreatment. (Clinicaltrials.gov Registration number: NCT03780933).