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

Abstract

Background: 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.