High-dose ascorbic acid for burn shock resuscitation may not improve outcomes

Jonathan Lin, Stephanie Falwell, David G Greenhalgh, Tina L Palmieri, Soman Sen

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

High dose ascorbic acid (HDAA) has been touted to ameliorate inflammation and reduce fluid requirements during burn shock resuscitation (BSR). Whether this leads to improved outcomes is not known. The authors’ aim for this study was to compare ventilator days, ventilator-associated pneumonia, and mortality between patients who did and did not receive HDAA during BSR. The authors performed a retrospective case control study from 2012 to 2015. They identified 38 patients (HDAA) who received HDAA during BSR. Using age and %TBSA, the authors identified and matched 42 control patients (CTL) who did not receive HDAA for BSR during that same time period. The authors collected data for age, %TBSA, hospital days (LOS), ventilator days (VENT), inhalation injury (INH), ventilator-associated pneumonia (VAP), and mortality (MORT). There were no differences in age and %TBSA or %TBSA of third-degree burn injury between groups. There was no significant difference in the incidence of INH (HDAA–52% vs CTL–36%, P = .17) and the groups had similar LOS and VENT. Additionally, there was no significant difference in VAP incidence (HDAA–29% vs CTL–14%, P = .13) or mortality (HDAA–26% vs CTL–23%, P = .8). HDAA patients had a numerically higher incidence of acute renal failure requiring dialysis (23 vs 7%, P = .06) which was confirmed in a multivariate analysis (odds ratio 5.4; 95% confidence interval 1.1–26). HDAA, while potentially reducing inflammation and fluid requirements during BSR, may not improve any meaningful outcomes such as ventilator requirements, ventilator-associated pneumonia, and mortality.

Original languageEnglish (US)
Pages (from-to)708-712
Number of pages5
JournalJournal of Burn Care and Research
Volume39
Issue number5
DOIs
StatePublished - Jan 1 2018

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ASJC Scopus subject areas

  • Surgery
  • Emergency Medicine
  • Rehabilitation

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