Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Apr 11;85(5):1523-1526.
doi: 10.1097/MS9.0000000000000615. eCollection 2023 May.

High-dose intravenous versus low-dose oral vitamin C in burn care: potential protective effects in the severely burned: a retrospective cohort study

Aldin Malkoc  1 , Seungwon Jong  1   2 , Kerry Fine  1 , David T Wong  1   2
Affiliations

High-dose intravenous versus low-dose oral vitamin C in burn care: potential protective effects in the severely burned: a retrospective cohort study

Aldin Malkoc et al. Ann Med Surg (Lond). .

Abstract

Antioxidant therapies, such as ascorbic acid may have an important role during the acute phase of burn management. However, there are mixed results on the most effective dose and method of administration of ascorbic acid in burn patients. In this study, we compared the efficacy of intravenously and orally administered ascorbic acid in second-degree burns greater than 20% total-body-surface-area.

Materials and methods: The hospital burn database was used to obtain data on all patients with second-degree or deeper burns of 20% total-body-surface-area or greater. Fourteen patients were selected at random to receive a scheduled dose of 1250 mg intravenous ascorbic acid every 6 h for 72 h. This was considered the high-dose group. During same period, 40 patients received scheduled 500 mg oral ascorbic acid every 6 h for 72 h and this was considered the low-dose group. We gathered sociodemographic and clinical variables associated with ascorbic acid dosing.

Results: In our study, statistically significant variables were fluid requirements (p<0.001), hospital stay (p=0.011), length of time intubated on ventilator (p<0.001), colloids used (p=0.002), and total procedures required (p=0.014). Despite higher modified Baux predicted mortality in the high-dose group (10 patients vs. 24 patients, p=0.026) there was no noted significant association in days until the first infection and mortality rate (p=0.451 and 0.326, respectively).

Conclusions: The calculated modified Baux predicted a higher mortality rate with the higher dosing group, yet this study did not find a mortality difference between the groups. We speculate that high-dose intravenous ascorbic acid may have protective effects in burn resuscitation. This finding may support some previous studies that found that high-dose ascorbic acid may improve clinical outcomes.

Keywords: Baux score; ascorbic acid; fluid requirements; total-burn-surface-area.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no financial conflict of interest with regard to the content of this report.

References

    1. Atiyeh BS, Gunn SWA, Dibo SA. Metabolic implications of severe burn injuries and their management: a systematic review of the literature. World J Surg 2008;32:1857–1869. - PubMed
    1. Matsuda T, Tanaka H, Shimazaki S, et al. . High-dose vitamin C therapy for extensive deep dermal burns. Burns 1992;18:127–131. - PubMed
    1. Malkoc A, Wong DT. Lessons learned from two survivors of greater than 90% TBSA full-thickness burn injuries using NovoSorb Biodegradable Temporizing MatrixTM and Autologous Skin Cell Suspension, RECELLTM: a case series. J Burn Care Res 2020;42:577–585. - PubMed
    1. Wang Y, Lin H, Lin BW, et al. . Effects of different ascorbic acid doses on the mortality of critically ill patients: a meta-analysis. Ann Intensive Care 2019;9:58. - PMC - PubMed
    1. Kahn SA, Beers RJ, Lentz CW. Resuscitation after severe burn injury using high-dose ascorbic acid: a retrospective review. J Burn Care Res 2011;32:110–117. - PubMed