High Dose Ascorbic Acid During Acute Resuscitation in Critically Burn Patients.

Area of Science:

• Resuscitation Medicine
• Burn Care
• Antioxidant Therapy

Background:

• Severe burns trigger systemic inflammation and oxidative stress.
• Ascorbic acid (AA) is a potent free radical scavenger with potential therapeutic benefits.
• High-dose ascorbic acid (HDAA) has been explored for its effects on fluid resuscitation and organ function in burn patients.

Purpose of the Study:

• To investigate the efficacy of HDAA in reducing fluid resuscitation requirements in severe burn patients.
• To assess the impact of HDAA on preventing organ dysfunction and complications.
• To evaluate the safety of HDAA, particularly concerning acute kidney injury.

Main Methods:

• Retrospective case-control study of 75 severe burn patients (TSBA > 30%).
• Comparison between 25 patients receiving HDAA (66 mg/kg/h for 36h) and 50 controls.
• Analysis of fluid requirements, Sequential Organ Failure Assessment (SOFA) scores, hemodynamic parameters, complications, and mortality.

Main Results:

• The HDAA group showed significantly lower fluid requirements in the first 24 hours (3.06 vs 4.32 ml/kg/%TBSA, P < .05).
• No significant difference in overall fluid requirements within 72 hours, SOFA scores, hemodynamic parameters, complications, or mortality between groups.
• No increased incidence of acute kidney injury in the HDAA group, despite a mean urine oxalate/creatinine ratio of 0.61.

Conclusions:

• HDAA administration in severe burn patients under restrictive fluid therapy can decrease initial fluid resuscitation needs.
• HDAA did not significantly impact total fluid intake, organ dysfunction, or mortality.
• HDAA appears safe regarding renal function in this patient cohort.