Only half of the patients suffering from cardiac arrest arrive at the hospital alive. Of
these survivors, more than 50% will still die or remain severely disabled. During cardiac
arrest ischemia causes damage to the vital organs, especially the brain. When with return of
spontaneous circulation oxygen is re-offered to the ischemic organs, massive amounts of
reactive oxygen species (ROS) are produced. These ROS can further increase the damage to the
myocardium and brain (reperfusion injury). Vitamin C is the primary circulating antioxidant.
It scavenges free radicals and reduces the production of ROS. In a recent study we
demonstrated that vitamin C plasma levels are deficient in ~60% of the patients after cardiac
arrest, probably due to massive consumption. Vitamin C deficiency reduces the protection
against oxidative stress. Intravenous supplementation is needed to restore deficiency and the
antioxidative effect of vitamin C is much more potent if it is administered in a
supraphysiological dose (≥ 3 g per day). Its strong antioxidative effect may reduce damage to
the circulation and to brain, heart and other organs. Beneficial effects of high dose i.v.
vitamin C after cardiac arrest have been demonstrated in preclinical studies, but not in
patients.
The investigators hypothesize that vitamin C can reduce organ damage, especially cerebral
injury, if administered for a short period as a high i.v. dose during the very early phase of
reperfusion after cardiac arrest.
Objectives:
- To determine whether an early high dose i.v. vitamin C can improve organ function,
especially neurological outcome, in patients after cardiac arrest
- To explore the optimal dosing regimen for high dose i.v. vitamin C
- To investigate in vitro the difference in effect of plasma obtained from post cardiac
arrest patients treated with placebo, 3 gr/day or 10 gr/day vitamin C on endothelial
cell viability and underlying oxidative pathways.
Phase:
Phase 2
Details
Lead Sponsor:
VU University Medical Center
Collaborators:
Amphia Hospital Erasmus Medical Center Gelderse Vallei Hospital Maasstad Hospital Noordwest Ziekenhuisgroep OLVG Sint Franciscus Gasthuis Tergooiziekenhuizen