High-dose intravenous vitamin C reduce C-reactive protein levels, fluid retention, and APACHE II scores in patients with moderately severe acute pancreatitis: a prospective, randomized, double-blinded, placebo-controlled study

Zhao, B; Sun, W; Wang, Y; Ma, L; Gui, M; Li, J; Yu, X; Qi, X; Ning, N; Sun, S; Li, M; Yao, Y; Ni, T; He, J; Yang, Z; Chen, Y; Sheng, H; Shen, M; Li, J; Huang, J; Mao, E

doi:10.1186/s13613-025-01437-z

Organ support & nutrition

High-dose intravenous vitamin C reduce C-reactive protein levels, fluid retention, and APACHE II scores in patients with moderately severe acute pancreatitis: a prospective, randomized, double-blinded, placebo-controlled study

Ann Intensive CarePublished 17 Mar 2025Randomised controlled trial

Primary result · 28-day mortalityResultUnadjusted odds ratio 0.70 95% CI 0.15–3.21

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Authors' conclusion

HDIVC did not significantly reduce 28-day mortality in MSAP and SAP patients.

Study context

Population: Adults with predicted moderately severe (moderately severe acute pancreatitis (MSAP)) or severe acute pancreatitis (SAP) within 72 h of symptom onset155 MSAP, 57 SAP
Participants: 212 adults

Comparison: High-dose IV vitamin C vs matched placebo for 7 days
High-dose intravenous vitamin C (HDIVC)n = 109
Controln = 103reference
Primary endpoint: 28-day mortality
Follow-up: 28 days

Methodological detailsdouble-blinded, placebo-controlled, Enrolled September 2019 to June 2023

Double-blinded
Placebo-controlled
Enrolled September 2019 to June 2023

Primary result

As reported in the abstract

Unadjusted odds ratio

0.70

95% CI 0.15–3.21

P = 0.647

Events by treatment group

HDIVC

3 of 109

Control

4 of 103

HDIVC vs Control

unadjusted OR 0.70 (95% CI 0.15–3.21); P = 0.647

Further findings

Fluid retention volume, MSAP (subgroup) · Day0-Day1

P = 0.04

HDIVCmedian 676.5 ml

Controlmedian 1130 ml

Fluid retention volume, MSAP (subgroup) · Day0-Day2

P = 0.02

HDIVCmedian 511 ml

Controlmedian 1290 ml

Fluid retention volume, MSAP (subgroup) · Day0-Day3

P = 0.04

HDIVCmedian 692 ml

Controlmedian 1534 ml

Outcome	HDIVC	Control	P value
CRP reduction, MSAP (subgroup) · Day0 to Day3Median, mg/L	72	46	P = 0.003
CRP reduction, MSAP (subgroup) · Day0 to Day7Median, mg/L	168	121	P = 0.013
APACHE II score reduction, MSAP (subgroup) · Day0 to Day7Median	3	2	P = 0.01

SAP (subgroup)

No significant difference among patients with SAP

Original publication

High-dose intravenous vitamin C reduce C-reactive protein levels, fluid retention, and APACHE II scores in patients with moderately severe acute pancreatitis: a prospective, randomized, double-blinded, placebo-controlled study. Ann Intensive Care. Published 17 March 2025. doi:10.1186/s13613-025-01437-z

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