論文

査読有り 国際誌
2020年7月

Harm of IV High-Dose Vitamin C Therapy in Adult Patients: A Scoping Review.

Critical care medicine
  • Fumitaka Yanase
  • ,
  • Tomoko Fujii
  • ,
  • Thummaporn Naorungroj
  • ,
  • Alessandro Belletti
  • ,
  • Nora Luethi
  • ,
  • Anitra C Carr
  • ,
  • Paul J Young
  • ,
  • Rinaldo Bellomo

48
7
開始ページ
e620-e628
終了ページ
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1097/CCM.0000000000004396

OBJECTIVES: The potential harm associated with the use of IV vitamin C has not been systematically assessed. We aimed to review the available evidence on harm related to such treatment. DATA SOURCES: We searched MEDLINE, EMBASE, Cochrane Library, National Institute of Health Clinical Trials Register, and World Health Organization International Clinical Trials Registry Platform. STUDY SELECTION: We included studies in adult population that reported harm related to IV high-dose vitamin C which we defined as greater than or equal to 6 g/d, greater than or equal to 75 mg/kg/d, or greater than or equal to 3 g/m/d. DATA EXTRACTION: Two independent investigators screened records and extracted data. DATA SYNTHESIS: We identified 8,149 reports, of which 650 full text were assessed for eligibility, leaving 74 eligible studies. In these studies, 2,801 participants received high-dose vitamin C at a median (interquartile range) dose of 22.5 g/d (8.25-63.75 g/d), 455 mg/kg/d (260-925 mg/kg/d), or 70 g/m/d (50-90 g/m/d); and 932 or more adverse events were reported. Among nine double-blind randomized controlled trials (2,310 patients), adverse events were reported in three studies with an event rate per patient for high-dose vitamin C identical to placebo group in one study (0.1 [1/10] vs 0.1 [1/10]), numerically lower in one study (0.80 [672/839] vs 0.82 [709/869]), and numerically higher in one study (0.33 [24/73] vs 0.23 [17/74]). Six double-blind randomized controlled trials reported no adverse event in either group. Five cases of oxalate nephropathy, five cases of hypernatremia, three cases of hemolysis in glucose-6-phosphate dehydrogenase deficiency patients, two cases of glucometer error, and one case of kidney stones were also reported overall. CONCLUSIONS: There is no consistent evidence that IV high-dose vitamin C therapy is more harmful than placebo in double-blind randomized controlled trials. However, reports of oxalate nephropathy, hypernatremia, glucometer error, and hemolysis in glucose-6-phosphate dehydrogenase deficiency patients warrant specific monitoring.

リンク情報
DOI
https://doi.org/10.1097/CCM.0000000000004396
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/32404636
ID情報
  • DOI : 10.1097/CCM.0000000000004396
  • PubMed ID : 32404636

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