scholarly journals Effect of Vitamin C on mortality of critically ill patients with severe pneumonia in intensive care unit: a preliminary study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ata Mahmoodpoor ◽  
Kamran Shadvar ◽  
Sarvin Sanaie ◽  
Mir Reza Hadipoor ◽  
Mohammad Ata Pourmoghaddam ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Mortality Rate ◽  
Vitamin C ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Intervention Group ◽  
Severe Pneumonia ◽  
High Dose ◽  
Significant Difference ◽  
Vasopressor Use

Abstract Background Critically ill patients frequently suffer from vitamin C deficiency. Previous studies showed that high doses of vitamin C administration had conflicting results on clinical outcomes in patients with severe sepsis, burns, and trauma. Because of the high incidence and morbidity/mortality with severe pneumonia, we aimed to investigate the effect of administration of high dose vitamin C in critically ill patients with severe pneumonia. Methods Eighty critically ill patients with pneumonia were enrolled in this randomized double-blinded clinical trial. Patients with a CURB-65 score > 3, one major criterion, or ≥ 3 minor criteria were considered as severe pneumonia. Patients were randomly assigned to intervention or placebo groups receiving standard treatment plus 60 mg/kg/day vitamin C as a continuous infusion or normal saline in the same volume correspondingly for 96 h. Serum levels of vitamin C were noted at baseline and 48 h after vitamin C administration. Duration of mechanical ventilation, ICU length of stay, PaO2/FiO2, and mortality rate were noted for all patients till the 28th day. Any complications related to the vitamin C administration were recorded. Results Duration of mechanical ventilation and vasopressor use were significantly lower in the intervention group (p: < 0.001 and 0.003, respectively). Baseline levels of vitamin C in both groups did not have a significant difference but its levels increased in the intervention group and decreased in the control group during the study period. Mortality rate insignificantly decreased in the intervention group (p = 0.17). Three patients showed hypotension and tachycardia during the administration of vitamin C which was self-limited with decreasing the dose of vitamin C. Our results showed that the intravenous administration of a relatively high dose of vitamin C to critically ill patients with severe pneumonia was safe and could decrease the inflammation, duration of mechanical ventilation, and vasopressor use without any significant effect on mortality. Trial registration: IRCT registration number: IRCT20190312043030N1, Registration date: 2019-08-26, Seied Hadi Saghaleini.

scholarly journals Effect of Vitamin C on mortality of critically ill patients with severe pneumonia in intensive care unit

2020 ◽  
Author(s):  
Ata Mahmoodpoor ◽  
Kamran Shadvar ◽  
Sarvin Sanaie ◽  
Mir Reza Hadipoor ◽  
Mohammad Ata Pourmoghaddam ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Mortality Rate ◽  
Vitamin C ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Intervention Group ◽  
Severe Pneumonia ◽  
High Dose ◽  
Significant Difference ◽  
Vasopressor Use

Abstract Background: Critically ill patients are frequently suffering from vitamin C deficiency. Previous studies showed that high doses of vitamin C administration had conflicting results on clinical outcomes in patients with severe sepsis, burns and trauma. Because of high incidence and morbidity/mortality with severe pneumonia, we aimed to investigate the effect of administration of high dose vitamin C in critically ill patients with severe pneumonia.Methods: Eighty critically ill patients with pneumonia were enrolled in this randomized double blinded clinical trial. Patients with CURB-65 score >3, one major criteria, or ≥3 minor criteria were considered as severe pneumonia. Patients were randomly assigned to intervention or placebo groups receiving standard treatment plus 60 mg/kg/day vitamin C as continuous infusion or normal saline in the same volume correspondingly for 96 hours. Serum levels of vitamin C were noted at baseline and 48 hours after vitamin C administration. Duration of mechanical ventilation, ICU length of stay, PaO2/FiO2 and mortality rate were noted for all patients till the 28th day. Any complications related to vitamin C administration were recorded. (IRCT registration number: IRCT20190312043030N1, Registration date: 2019-08-26, seied hadi saghaleini).Results: Duration of mechanical ventilation and vasopressor use were significantly lower in intervention group (p: <0.001 and 0.003, respectively). Baseline levels of vitamin C in both groups did not have significant difference but its levels increased in intervention group and decreased in control group during the study period. Mortality rate insignificantly decreased in intervention group (p: 0.17). Three patients showed hypotension and tachycardia during the administration of vitamin C which was self-limited with decreasing the dose of vitamin C. Conclusion: Our results showed that the intravenous administration of a relatively high dose of vitamin C to critically ill patients with severe pneumonia was safe and could decrease the inflammation, mechanical ventilation duration and vasopressor use without any significant effect on mortality.

scholarly journals Effect of Vitamin C on mortality of critically ill patients with severe pneumonia in intensive care unit: A preliminary study

2021 ◽  
Author(s):  
Ata Mahmoodpoor ◽  
Kamran Shadvar ◽  
Sarvin Sanaie ◽  
Mir Reza Hadipoor ◽  
Mohammad Ata Pourmoghaddam ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Mortality Rate ◽  
Vitamin C ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Intervention Group ◽  
Severe Pneumonia ◽  
High Dose ◽  
Significant Difference ◽  
Vasopressor Use

Abstract Background: Critically ill patients frequently suffer from vitamin C deficiency. Previous studies showed that high doses of vitamin C administration had conflicting results on clinical outcomes in patients with severe sepsis, burns and trauma. Because of the high incidence and morbidity/mortality with severe pneumonia, we aimed to investigate the effect of administration of high dose vitamin C in critically ill patients with severe pneumonia. Methods: Eighty critically ill patients with pneumonia were enrolled in this randomized double blinded clinical trial. Patients with CURB-65 score >3, one major criteria, or ≥3 minor criteria were considered as severe pneumonia. Patients were randomly assigned to intervention or placebo groups receiving standard treatment plus 60 mg/kg/day vitamin C as continuous infusion or normal saline in the same volume correspondingly for 96 hours. Serum levels of vitamin C were noted at baseline and 48 hours after vitamin C administration. Duration of mechanical ventilation, ICU length of stay, PaO 2 /FiO 2 and mortality rate were noted for all patients till the 28 th day. Any complications related to the vitamin C administration were recorded. (IRCT registration number: IRCT20190312043030N1 , Registration date: 2019-08-26 , seied hadi saghaleini). Results: Duration of mechanical ventilation and vasopressor use were significantly lower in intervention group ( p : <0.001 and 0.003, respectively). Baseline levels of vitamin C in both groups did not have significant difference but its levels increased in intervention group and decreased in control group during the study period. Mortality rate insignificantly decreased in intervention group ( p : 0.17). Three patients showed hypotension and tachycardia during the administration of vitamin C which was self-limited with decreasing the dose of vitamin C. Conclusion: Our results showed that the intravenous administration of a relatively high dose of vitamin C to critically ill patients with severe pneumonia was safe and could decrease the inflammation, duration of mechanical ventilation and vasopressor use without any significant effect on mortality ( P value: 0.17).

scholarly journals Effect of Vitamin C on mortality of critically ill patients with severe pneumonia in intensive care unit

2020 ◽  
Author(s):  
Ata Mahmoodpoor ◽  
Kamran Shadvar ◽  
Sarvin Sanaie ◽  
Mir Reza Hadipoor ◽  
Mohammad Ata Pourmoghaddam ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Mortality Rate ◽  
Vitamin C ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Intervention Group ◽  
Severe Pneumonia ◽  
High Dose ◽  
Significant Difference ◽  
Vasopressor Use

Abstract Background: Critically ill patients are frequently suffering from vitamin C deficiency. Previous studies showed that high doses of vitamin C administration had conflicting results on clinical outcomes in patients with severe sepsis, burns and trauma. Because of high incidence and morbidity/mortality with severe pneumonia, we aimed to investigate the effect of administration of high dose vitamin C in critically ill patients with severe pneumonia.Methods: Eighty critically ill patients with pneumonia were enrolled in this randomized double blinded clinical trial. Patients with CURB-65 score >3, one major criteria, or ≥3 minor criteria were considered as severe pneumonia. Patients were randomly assigned to intervention or placebo groups receiving standard treatment plus 60 mg/kg/day vitamin C as continuous infusion or normal saline in the same volume correspondingly for 96 hours. Serum levels of vitamin C were noted at baseline and 48 hours after vitamin C administration. Duration of mechanical ventilation, ICU length of stay, PaO2/FiO2 and mortality rate were noted for all patients till the 28th day. Any complications related to vitamin C administration were recorded. (IRCT registration number: IRCT20190312043030N1 , Registration date: 2019-08-26, seied hadi saghaleini).Results: Duration of mechanical ventilation and vasopressor use were significantly lower in intervention group (p: <0.001 and 0.003, respectively). Baseline levels of vitamin C in both groups did not have significant difference but its levels increased in intervention group and decreased in control group during the study period. Mortality rate insignificantly decreased in intervention group (p: 0.17). Three patients showed hypotension and tachycardia during the administration of vitamin C which was self-limited with decreasing the dose of vitamin C.Conclusion: Our results showed that the intravenous administration of a relatively high dose of vitamin C to critically ill patients with severe pneumonia was safe and could decrease the inflammation, mechanical ventilation duration and vasopressor use without any significant effect on mortality.

scholarly journals Effects of a High Dose of Vitamin C along with Thiamine in Critically-ill Patients with Septic Shock: A Preliminary Study

2019 ◽  
pp. 1-7
Author(s):  
Hasanali Karimpour ◽  
Alireza Bahrami ◽  
Shila Amini ◽  
Mansour Rezaei ◽  
Javad Amini-Saman ◽  
...  
Keyword(s):  
Septic Shock ◽  
Vitamin C ◽  
Critically Ill ◽  
Sofa Score ◽  
Critically Ill Patients ◽  
Lactate Concentration ◽  
Intervention Group ◽  
Treatment Modalities ◽  
Control Group ◽  
High Dose

Septic shock may occur in critically ill patients and despite antimicrobial treatment, it is associated with a high mortality rate. It is reasonable to look for new treatment modalities that might improve outcome. This is a randomized, double-blind control trial aiming at critically-ill septic patients in a tertiary hospital. Patients with quick sofa score of 2 and with organ dysfunction were included in this study. The intervention group received high doses of vitamin C at a dose of 50 mg/kg/four times daily along with thiamine at a dose of 200 mg/ twice daily) and the control group received normal saline for four days. The dose of vasopressors, procalcitonin and lactate clearance, and mean sequential organ failure assessment (SOFA) score were examined in the two groups. Patients were followed for 28 days. One hundred patients were allocated into two equal groups, and there was no difference between the two groups regarding baseline characteristics. Mean lactate concentration, SOFA score, days of antimicrobial therapy, and mortality at 28 days were similar between them. However, the mean procalcitonin concentration, and mean vasopressor treatment hours were significantly lower in the intervention group (p<0.05). Although Days of ICU stay were lower in the intervention group, It did not reach statistical significance. The results of this study showed that treatment with high dose vitamin C Reduces the vasopressor requirement without any effects on other parameters. Further studies with larger sample size are required for more generalizable results.

scholarly journals Effect of intracutaneous pyonex on analgesia and sedation in critically ill patients with mechanical ventilation

2021 ◽  
Author(s):  
Yuanyuan Wang ◽  
Wenhua Wu ◽  
Jie Zhang ◽  
Jia Sun ◽  
Jiling Wang ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Treatment Period ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Compliance Rate ◽  
Intervention Group ◽  
Gas Analysis ◽  
Control Group ◽  
Analgesic Drugs ◽  
Significant Difference

To evaluate the effect of intracutaneous pyonex on analgesia and sedation in critically ill patients who underwent mechanical ventilation. A total of 88 critically ill patients were divided into control group and intervention group. Critical-Care Pain Observation Tool (CPOT) and Richmond Agitation and Sedation Scale (RASS) were used to evaluate pain and agitation. The dosage and treatment period of sedative and analgesic drugs in the intervention group were notably lower than the control group (p<0.05). Analgesia compliance time in the intervention group was superior to control group (p<0.05). The shallow sedation compliance rate in the intervention group was significantly higher than the control group (p<0.01). There was significant difference in blood gas analysis before and after treatment between the two groups (p<0.05). After 2 h of sedation and analgesia, heart rate (HR) in the intervention group was lower than control group, but respiratory rate (RR) was higher than the control group (p<0.05). The traditional analgesia and sedation combined with intracutaneous pyonex reduced the total amount and treatment period of sedative and analgesic drugs in critically ill patients throughout the treatment process, while it also decreased the adverse reactions such as blood pressure drops and respiratory depression.

scholarly journals Physical methods for the treatment of fever in critically ill patients: a randomized controlled trial

2016 ◽  
Vol 50 (5) ◽  
pp. 823-830 ◽  
Author(s):  
Patrícia de Oliveira Salgado ◽  
Ludmila Christiane Rosa da Silva ◽  
Priscila Marinho Aleixo Silva ◽  
Tânia Couto Machado Chianca
Keyword(s):  
Body Temperature ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Intervention Group ◽  
Tympanic Temperature ◽  
Control Group ◽  
Physical Methods ◽  
Group I ◽  
Significant Difference ◽  
Ice Pack

Abstract OBJECTIVE To evaluate the effects of physical methods of reducing body temperature (ice pack and warm compression) in critically ill patients with fever. METHOD A randomized clinical trial involving 102 adult patients with tympanic temperature ≥ 38.3°C of an infectious focus, and randomized into three groups: Intervention I - ice pack associated with antipyretic; Intervention II - warm compress associated with antipyretic; and Control - antipyretic. Tympanic temperature was measured at 15 minute intervals for 3 hours. The effect of the interventions was evaluated through the Mann-Whitney test and Survival Analysis. "Effect size" calculation was carried out. RESULTS Patients in the intervention groups I and II presented greater reduction in body temperature. The group of patients receiving intervention I presented tympanic temperature below 38.3°C at 45 minutes of monitoring, while the value for control group was lower than 38.3°C starting at 60 minutes, and those who received intervention II had values lower than 38.3°C at 75 minutes of monitoring. CONCLUSION No statistically significant difference was found between the interventions, but with the intervention group I patients showed greater reduction in tympanic temperature compared to the other groups. Brazilian Registry of Clinical Trials: RBR-2k3kbq

scholarly journals Tigecycline Therapy for Nosocomial Pneumonia due to Carbapenem-Resistant Gram-Negative Bacteria in Critically Ill Patients Who Received Inappropriate Initial Antibiotic Treatment: A Retrospective Case Study

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Xiaomai Wu ◽  
Yefei Zhu ◽  
Qiuying Chen ◽  
Liuyang Gong ◽  
Jian Lin ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Critically Ill ◽  
Nosocomial Pneumonia ◽  
Critically Ill Patients ◽  
Standard Dose ◽  
High Dose ◽  
Gram Negative Bacteria ◽  
Loading Dose ◽  
Icu Mortality ◽  
Carbapenem Resistant

Background. Nosocomial pneumonia due to carbapenem-resistant Gram-negative bacteria (CRGNB) is a growing concern because treatment options are limited and the mortality rate is high. The effect of tigecycline (TGC) on nosocomial pneumonia due to CRGNB in patients who have received inappropriate initial empiric antibiotic treatment (IIAT) is unclear. Therefore, this study aimed to examine the effect of TGC on nosocomial pneumonia due to CRGNB in critically ill patients who had received IIAT. Methods. A retrospective study was conducted in an adult respiratory intensive care unit. Data were obtained and analyzed for all patients who were treated with TGC ≥ 3 days for microbiologically confirmed nosocomial pneumonia due to CRGNB and had experienced initial antibiotic failure. Clinical and microbiological outcomes were investigated. Results. Thirty-one patients with hospital-acquired pneumonia or ventilator-associated pneumonia were included in the study. The majority of the responsible organisms were carbapenem-resistant Acinetobacter baumannii (67.7%), followed by Klebsiella pneumoniae (16.1%) and Escherichia coli (9.7%). Twenty patients were treated with high-dose TGC therapy (100 mg every 12 h after a 200 mg loading dose), and the others received a standard-dose therapy (50 mg every 12 h after a 100 mg loading dose). The duration of TGC therapy was 14.3±2.8 days. The global clinical cure rate and the microbiological eradication rate were 48.4% and 61.3%, respectively. The overall ICU mortality rate was 45.2%. A higher score on the Acute Physiology and Chronic Health Evaluation II and a longer duration of IIAT were associated with clinical failure. High-dose TGC therapy had a higher clinical success rate [65.0% (13/20) versus 18.2% (2/11), P=0.023] and a lower ICU mortality rate [30.0% (6/20) versus 72.7% (8/11), P=0.031] than the standard-dose therapy. Conclusions. TGC, especially a high-dose regimen, might be a justifiable option for critically ill patients with nosocomial pneumonia due to CRGNB who have received IIAT when the options for these patients are limited.

Electroacupuncture Reduces the Dose of Midazolam Monitored by the Bispectral Index in Critically Ill Patients with Mechanical Ventilation: An Exploratory Study

2012 ◽  
Vol 30 (2) ◽  
pp. 78-84 ◽  
Author(s):  
Xia Zheng ◽  
Jian-biao Meng ◽  
Qiang Fang
Keyword(s):  
Mechanical Ventilation ◽  
Critically Ill ◽  
Bispectral Index ◽  
Critically Ill Patients ◽  
Additional Treatment ◽  
Acupuncture Points ◽  
Sedative Drug ◽  
Significant Difference ◽  
Group A ◽  
Group B

Objective Electroacupuncture, a modern variation on a traditional Chinese treatment, might be useful for sedation and analgesia. This study aims to investigate whether electroacupuncture can modify the dose of midazolam monitored by the bispectral index (BIS) in critically ill patients with mechanical ventilation. Methods Orotracheally intubated patients undergoing mechanical ventilation were randomly assigned into three groups (groups A, B and C). All patients were given an intravenous infusion of midazolam. Patients in group A received no additional treatment. Patients in group B were given acupuncture without electrical stimulation at acupuncture points GV24 and EX–HN3 ( Yintang) for 6 h simultaneously, and patients in group C were given electroacupuncture to the same points as in group B. Results Maintaining the BIS between 60 and 80, the hourly mean one dose of midazolam within the first 6 h after sedation in group C was 0.05 (±0.02 mg/kg per hour), which was significantly lower than both group A (0.08±0.03 mg/kg per hour, p<0.001) and group B (0.07±0.01 mg/kg per hour, p<0.021). The doses in groups A and B showed no significant difference. Between-group comparison analysis of hepatic and renal function and severe adverse reactions all showed no significant difference between the three groups. Conclusions Electroacupuncture appears to reduce markedly the dose of sedative drug required in critically ill patients with mechanical ventilation monitored by BIS, without any obvious severe adverse action, and larger studies to confirm the effect are justified.

scholarly journals Obesity May Not Be Associated with 28-Day Mortality, Duration of Invasive Mechanical Ventilation and Length of Intensive Care Unit and Hospital Stay in Critically Ill Patients with Severe Acute Respiratory Syndrome Coronavirus-2: A Retrospective Cohort Study

Medicina ◽  
2021 ◽  
Vol 57 (7) ◽  
pp. 674
Author(s):  
Sjaak Pouwels ◽  
Dharmanand Ramnarain ◽  
Emily Aupers ◽  
Laura Rutjes-Weurding ◽  
Jos van Oers
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Cohort Study ◽  
Intensive Care ◽  
Length Of Stay ◽  
Hospital Stay ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Invasive Mechanical Ventilation ◽  
Significant Difference

Background and Objectives: The aim of this study was to investigate the association between obesity and 28-day mortality, duration of invasive mechanical ventilation and length of stay at the Intensive Care Unit (ICU) and hospital in patients admitted to the ICU for SARS-CoV-2 pneumonia. Materials and Methods: This was a retrospective observational cohort study in patients admitted to the ICU for SARS-CoV-2 pneumonia, in a single Dutch center. The association between obesity (body mass index > 30 kg/m2) and 28-day mortality, duration of invasive mechanical ventilation and length of ICU and hospital stay was investigated. Results: In 121 critically ill patients, pneumonia due to SARS-CoV-2 was confirmed by RT-PCR. Forty-eight patients had obesity (33.5%). The 28-day all-cause mortality was 28.1%. Patients with obesity had no significant difference in 28-day survival in Kaplan–Meier curves (log rank p 0.545) compared with patients without obesity. Obesity made no significant contribution in a multivariate Cox regression model for prediction of 28-day mortality (p = 0.124), but age and the Sequential Organ Failure Assessment (SOFA) score were significant independent factors (p < 0.001 and 0.002, respectively). No statistically significant correlation was observed between obesity and duration of invasive mechanical ventilation and length of ICU and hospital stay. Conclusion: One-third of the patients admitted to the ICU for SARS-CoV-2 pneumonia had obesity. The present study showed no relationship between obesity and 28-day mortality, duration of invasive mechanical ventilation, ICU and hospital length of stay. Further studies are needed to substantiate these findings.

Sign in / Sign up

Export Citation Format

Share Document