Vitamin C may have adverse effects in ICU patients after cardiac arrest

Overview

A recent trial found that high-dose vitamin C may worsen organ dysfunction in ICU patients following out-of-hospital cardiac arrest. The study indicated a significant increase in adverse outcomes, particularly in the group receiving 10 g of vitamin C daily.

Background

The potential benefits of vitamin C in critical illness have been debated, particularly regarding its antioxidant properties and ability to mitigate organ dysfunction after cardiac arrest. However, previous studies in sepsis have raised concerns about the safety of high-dose vitamin C, suggesting that it may lead to worse outcomes.

Data Highlights

Key Findings

• Organ dysfunction worsened in the 10 g vitamin C group compared to placebo.
• The 3 g vitamin C group showed a smaller increase in organ dysfunction.
• Higher doses of vitamin C were associated with increased need for kidney replacement therapy.
• Patients receiving high-dose vitamin C developed ICU-acquired weakness more frequently.
• Biomarker analyses indicated higher troponin concentrations in the 10 g group.
• Overall patient-centered outcomes were less favorable with vitamin C treatment.

Clinical Implications

The findings indicate potential harm in patients following out-of-hospital cardiac arrest.

Conclusion

The study's results indicate that vitamin C, especially in the doses tested, may not be beneficial after out-of-hospital cardiac arrest.

Related Resources & Content

1. Intensive Care Medicine, 2023 -- Early high-dose vitamin C for out-of-hospital cardiac arrest: the VITaCCA randomized clinical trial
2. Intensive Care Medicine, 2018 -- Adjuvant Vitamin Supplementation in Critically Ill Patients: Emphasis on Thiamine, Vitamin C, and Vitamin D
3. Conexiant, 2023 -- High-Dose Vitamin C Could Pose Risk in Severe Burns
4. American Heart Association, 2025 -- Part 11: Post-Cardiac Arrest Care
5. European Resuscitation Council and European Society of Intensive Care Medicine, 2025 -- Guidelines 2025 Post-Resuscitation Care
6. Frontiers in Medicine — The association between the sodium-potassium ratio and ICU mortality in cardiac arrest patients: an analysis of the eICU database
7. Addition of Vitamin C Does Not Decrease Neuron-Specific Enolase Levels in Adult Survivors of Cardiac Arrest
8. Intravenous Vitamin C in Adults with Sepsis in the Intensive Care Unit
9. Part 11: Post-Cardiac Arrest Care | American Heart Association CPR & First Aid
10. European Resuscitation Council and European Society of Intensive Care Medicine Guidelines 2025 Post-Resuscitation Care
11. Early administration of vitamin C in patients with sepsis or septic shock in emergency departments: a multicenter, double-blind, randomized controlled trial: the C-EASIE trial