論文

査読有り 国際誌
2019年12月

Pharmacokinetic data support 6-hourly dosing of intravenous vitamin C to critically ill patients with septic shock.

Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine
  • Elizabeth P Hudson
  • ,
  • Jake Tb Collie
  • ,
  • Tomoko Fujii
  • ,
  • Nora Luethi
  • ,
  • Andrew A Udy
  • ,
  • Sarah Doherty
  • ,
  • Glenn Eastwood
  • ,
  • Fumitaka Yanase
  • ,
  • Thummaporn Naorungroj
  • ,
  • Laurent Bitker
  • ,
  • Yasmine Ali Abdelhamid
  • ,
  • Ronda F Greaves
  • ,
  • Adam M Deane
  • ,
  • Rinaldo Bellomo

21
4
開始ページ
236
終了ページ
42
記述言語
英語
掲載種別

OBJECTIVES: To study vitamin C pharmacokinetics in septic shock. DESIGN: Prospective pharmacokinetic study. SETTING: Two intensive care units. PARTICIPANTS: Twenty-one patients with septic shock enrolled in a randomised trial of high dose vitamin C therapy in septic shock. INTERVENTION: Patients received 1.5 g intravenous vitamin C every 6 hours. Plasma samples were obtained before and at 1, 4 and 6 hours after drug administration, and vitamin C concentrations were measured by high performance liquid chromatography. MAIN OUTCOME MEASURES: Clearance, volume of distribution, and half-life were calculated using noncompartmental analysis. Data are presented as median (interquartile range [IQR]). RESULTS: Of the 11 participants who had plasma collected before any intravenous vitamin C administration, two (18%) were deficient (concentrations < 11 μmol/L) and three (27%) had hypovitaminosis C (concentrations between 11 and 23 μmol/L), with a median concentration 28 μmol/L (IQR, 11-44 μmol/L). Volume of distribution was 23.3 L (IQR, 21.9-27.8 L), clearance 5.2 L/h (IQR, 3.3-5.4 L/h), and half-life 4.3 h (IQR, 2.6-7.5 h). For the participants who had received at least one dose of intravenous vitamin C before sampling, T0 concentration was 258 μmol/L (IQR, 162- 301 μmol/L). Pharmacokinetic parameters for subsequent doses were a median volume of distribution 39.9 L (IQR, 31.4-44.4 L), clearance 3.6 L/h (IQR, 2.6-6.5 L/h), and half-life 6.9 h (IQR, 5.7-8.5 h). CONCLUSION: Intravenous vitamin C (1.5 g every 6 hours) corrects vitamin C deficiency and hypovitaminosis C and provides an appropriate dosing schedule to achieve and maintain normal or elevated vitamin C levels in septic shock.

リンク情報
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/31778629
ID情報
  • ISSN : 1441-2772
  • PubMed ID : 31778629

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