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Background <p>Besides temperature management, there is currently no effective therapy to decrease the burden of post-cardiac arrest syndrome. The pleiotropic effects of vitamin C may improve clinical outcome.</p> Purpose <p>This trial investigated whether early administration of 3&#xa0;g or 10&#xa0;g intravenous vitamin C attenuated organ dysfunction post-cardiac arrest.</p> Methods <p>In this double-blind, multi-center, phase 2 trial, comatose adults resuscitated from shockable out-of-hospital cardiac arrest randomly received intravenously placebo, supplementary (3&#xa0;g) or supraphysiological dose (10&#xa0;g) vitamin C daily for 96 h. The primary endpoint was the 96&#xa0;h change in the resuscitation-sequential organ failure assessment (R-SOFA) score. Secondary endpoints included neurological outcome, myocardial injury, vasopressor- and ventilator-free days, renal function, ICU-acquired weakness, delirium, length of ICU and hospital stay, and 28- and 180-day mortality.</p> Results <p>273 patients (93 on&#xa0;placebo, 91&#xa0;on 3&#xa0;g and 89 on&#xa0;10&#xa0;g) were included in the primary analysis. Mean (SD) change in R-SOFA score at 96&#xa0;h was − 3.2 (5.7) in the placebo group, − 2.3 (7.4) in the 3&#xa0;g group, and − 0.8 (7.6) in the 10&#xa0;g group (p = 0.04 for overall difference). 10&#xa0;g vitamin C resulted in 2.5 points less improvement in R-SOFA score compared with placebo (95% CI 0.5–4.5; p = 0.01), and 1.6 points less improvement compared with 3&#xa0;g vitamin C (95% CI − 0.4 to 3.6; p = 0.12). Vitamin C 10&#xa0;g led to higher troponin T release, worse renal function and worse neurological outcomes.</p> Conclusion <p>In out-of-hospital cardiac arrest patients, intravenous vitamin C did not reduce organ dysfunction at 96&#xa0;h, but even worsened organ function outcomes in the 10&#xa0;g group.</p> Trial registration <p>NCT03509662.</p> Visual abstract <p></p>

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Early high-dose vitamin C for out-of-hospital cardiac arrest: the VITaCCA randomized clinical trial

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月16日

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  • Sander Rozemeijer,
  • Eric A. Dubois,
  • Harm-Jan de Grooth,
  • Corstiaan A. den Uil,
  • Thijs C. D. Rettig,
  • Tom A. Rijpstra,
  • Bas van den Bogaard,
  • Arthur R. H. van Zanten,
  • Rob J. Bosman,
  • Paul W. G. Elbers,
  • Armand R. J. Girbes,
  • Alexander P. J. Vlaar,
  • Jos W. R. Twisk,
  • Kenneth B. Christopher,
  • Patrick Schober,
  • Heleen M. Oudemans-van Straaten,
  • Angélique M. E. de Man

摘要

Background

Besides temperature management, there is currently no effective therapy to decrease the burden of post-cardiac arrest syndrome. The pleiotropic effects of vitamin C may improve clinical outcome.

Purpose

This trial investigated whether early administration of 3 g or 10 g intravenous vitamin C attenuated organ dysfunction post-cardiac arrest.

Methods

In this double-blind, multi-center, phase 2 trial, comatose adults resuscitated from shockable out-of-hospital cardiac arrest randomly received intravenously placebo, supplementary (3 g) or supraphysiological dose (10 g) vitamin C daily for 96 h. The primary endpoint was the 96 h change in the resuscitation-sequential organ failure assessment (R-SOFA) score. Secondary endpoints included neurological outcome, myocardial injury, vasopressor- and ventilator-free days, renal function, ICU-acquired weakness, delirium, length of ICU and hospital stay, and 28- and 180-day mortality.

Results

273 patients (93 on placebo, 91 on 3 g and 89 on 10 g) were included in the primary analysis. Mean (SD) change in R-SOFA score at 96 h was − 3.2 (5.7) in the placebo group, − 2.3 (7.4) in the 3 g group, and − 0.8 (7.6) in the 10 g group (p = 0.04 for overall difference). 10 g vitamin C resulted in 2.5 points less improvement in R-SOFA score compared with placebo (95% CI 0.5–4.5; p = 0.01), and 1.6 points less improvement compared with 3 g vitamin C (95% CI − 0.4 to 3.6; p = 0.12). Vitamin C 10 g led to higher troponin T release, worse renal function and worse neurological outcomes.

Conclusion

In out-of-hospital cardiac arrest patients, intravenous vitamin C did not reduce organ dysfunction at 96 h, but even worsened organ function outcomes in the 10 g group.

Trial registration

NCT03509662.

Visual abstract