High-dose Intravenous Vitamin C in Patients With Septic Shock (HIGH-VIS)
Sepsis, Severe, Septic Shock
About this trial
This is an interventional treatment trial for Sepsis, Severe
Eligibility Criteria
Inclusion Criteria:
- Diagnosis of septic shock within 24 hours of admission to the ICU
- Age 18 - 80 years
- Presence of a central venous catheter for vasopressor infusion
- Presence of an arterial line to monitor blood pressure
Definition of sepsis Suspected or documented infection and an increase of ≥ 2 SOFA points consequent to the infection.
Definition of septic shock Sepsis AND an arterial lactate >2 mmol/L AND need for vasopressor therapy to keep MAP >65 mmHg for > 2 hours despite fluid resuscitation therapy.
Exclusion Criteria:
- Age <18 or > 80 years
- Pregnant
- DNI (do not intubate) orders i.e., Goals of Care other than A
- Patients with a primary admission diagnosis of a traumatic brain injury
- Patients with features of septic shock admitted in the ICU > 24 hours
- Patients with a known history of glucose-6 phosphate dehydrogenase (G-6PD) deficiency
- Patients with a history of renal stones
- Patients with known or suspected scurvy
- Patients previously enrolled in this study
- Plasma sodium >150 mmol/L
- Plasma sodium < 130 mmol/L
- Haemoglobin < 90 g/L
- Jehova's witness
- Receiving isoprenaline
Sites / Locations
- Intensive Care Unit Royal Melbourne HospitalRecruiting
Arms of the Study
Arm 1
Arm 2
Arm 3
Experimental
Experimental
No Intervention
Intermediate dose
High dose
Usual care
Sodium ascorbate (vitamin C) is provided by the manufacturer (Orthomolecular Medisearch Laboratory P/L, Braeside, Victoria, Australia) as 30 grams in 100 ml. 30 gram load over 2 hours (T = 0 - 2 hours) 30 gram infusion over 6 hours (T = 2-8 hours) which will be repeated at 14, 26 and 38 hours
Sodium ascorbate (vitamin C) is provided by the manufacturer (Orthomolecular Medisearch Laboratory P/L, Braeside, Victoria, Australia) as 30 grams in 100 ml. 30 gram load over 2 hours (T = 0 - 2 hours) 60 gram infusion over 6 hours (T = 2-8 hours) which will be repeated at 14, 26 and 38 hours
Usual care for septic shock. No vitamin C will be given