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Trial registered on ANZCTR
Registration number
ACTRN12617000793314
Ethics application status
Approved
Date submitted
25/05/2017
Date registered
30/05/2017
Date last updated
20/12/2018
Date data sharing statement initially provided
20/12/2018
Type of registration
Prospectively registered
Titles & IDs
Public title
The Vitamin C after Cardiac Surgery Study
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Scientific title
A Pilot, Randomised, Double-Blind Study of Vitamin C in the treatment of Vasoplegic Shock after Cardiac Surgery
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Secondary ID [1]
292044
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Nil known
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Universal Trial Number (UTN)
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Trial acronym
The VICCSS study
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Low blood pressure
303443
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Vasoplegia
303466
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Condition category
Condition code
Cardiovascular
302851
302851
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0
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Other cardiovascular diseases
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Surgery
302873
302873
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0
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Other surgery
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Intravenous Vitamin C 1500 mg administered 6-hourly given every six hours until no vasopressor is required for a period of 24 hours or a maximum of 96 hours (4 days) or the patient is discharged from ICU, whichever occurs first) with clinical monitoring and evaluation of the patient's blood pressure prior to study drug administration
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Intervention code [1]
298170
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Treatment: Drugs
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Comparator / control treatment
Intravenous normal saline 0.9% administered 6-hourly given every six hours until no vasopressor is required for a period of 24 hours or a maximum of 96 hours (4 days) or the patient is discharged from ICU, whichever occurs first).with clinical monitoring and evaluation of the patient's blood pressure prior to study drug administration
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Cessation of vasopressor therapy
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Assessment method [1]
302246
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Timepoint [1]
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Cessation of vasopressor therapy is defined as the time from randomisation to cessation of vasopressor therapy (defined as four consecutive hours of vasopressor-free time).
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Secondary outcome [1]
335267
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Total dose of noradrenaline given in the first 48-hours following randomisation
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Assessment method [1]
335267
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Timepoint [1]
335267
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Accumulative dose in milligrams of noradrenaline administered from randomisation until 48-hours post randomisation as documented in the patient's medical record
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Secondary outcome [2]
335268
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Duration of intensive care unit admission
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Assessment method [2]
335268
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Timepoint [2]
335268
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Duration in hours from randomisation until discharge from the intensive care unit as documented in the patient's medical record
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Secondary outcome [3]
335269
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Mortality at ICU discharge
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Assessment method [3]
335269
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Timepoint [3]
335269
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Mortality status at the time of intensive care unit dischage as documented in the patient's medical record
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Secondary outcome [4]
335270
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Mortality at hospital discharge
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Assessment method [4]
335270
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Timepoint [4]
335270
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Mortality status at the time of hospital dischage as documented in the patient's medical record
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Eligibility
Key inclusion criteria
Patients aged greater than or equal to 18 years
Admitted to the ICU for less than 6 hours following cardiac surgery
Vasoplegic syndrome in the postoperative period defined as:
a) need for continuous vasopressor infusion to maintain a mean arterial pressure greater than 65 mmHg AND
b) cardiac index equal to or greater than 2.2 L/min/m2 OR central venous O2 saturation less than 60%
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Pregnancy
Use of vasopressors or inotropes in the preoperative period
Off-pump cardiac surgery
Chronic use of corticosteroid therapy
History of oxalate nephrolithiasis
Haemochromatosis
Glucose 6 phosphate dehydrogenase deficiency
Treating physician believes there is a cause for shock other than vasoplegic syndrome (eg: bleeding, fluid requirement, pneumothorax, pacemaker issues, or heart failure)
Treating clinician believes the study is not in the patient’s best interests
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Blinded allocation using sealed opaque envelopes
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
permuted block randomisation
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 2
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
Outcomes will be compared after log transformation where appropriate. Comparisons will be made using t-test and ANOVA for repeated-measures or Wilcoxon rank-signed test and Kruskall-Wallis according to the underlying distribution for continuous data and Chi-square for categorical data. Logistic regression analysis will also be performed to adjust for baseline imbalances. Analysis will be on an intention-to-treat basis.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
26/06/2017
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Actual
9/11/2017
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Date of last participant enrolment
Anticipated
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Actual
24/10/2018
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Date of last data collection
Anticipated
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Actual
19/12/2018
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Sample size
Target
50
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Accrual to date
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Final
50
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
8149
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Austin Health - Austin Hospital - Heidelberg
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Recruitment postcode(s) [1]
16210
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3084 - Heidelberg
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Recruitment outside Australia
Country [1]
9491
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New Zealand
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State/province [1]
9491
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Wellington
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Funding & Sponsors
Funding source category [1]
296575
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Hospital
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Name [1]
296575
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Austin Hospital
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Address [1]
296575
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Department of Intensive Care
Austin Hospital
145 Studley Road
Heidelberg VIC 3084
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Country [1]
296575
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Australia
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Primary sponsor type
Hospital
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Name
Austin Hospital
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Address
145 Studley Road
Heidelberg VIC 3084
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Country
Australia
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Secondary sponsor category [1]
295532
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Individual
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Name [1]
295532
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Professor Rinaldo Bellomo
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Address [1]
295532
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Director, Intensive Care Research
Department of Intensive Care
Austin Hospital
145 Studley Road
Heidelberg VIC 3084
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Country [1]
295532
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
297792
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Austin Health Human Research Ethics Committee
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Ethics committee address [1]
297792
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Austin Hospital 145 Studley Road Heidelberg VIC 3084
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Ethics committee country [1]
297792
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Australia
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Date submitted for ethics approval [1]
297792
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03/04/2017
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Approval date [1]
297792
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17/05/2017
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Ethics approval number [1]
297792
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HREC/17/Austin/162
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Summary
Brief summary
Patients after cardiac surgery often develop a low blood pressure because of the inflammation associated with surgery and bypass. This low blood pressure is mostly due to the small blood vessels losing their normal tightness. This condition is called “vasoplegia”. When vasoplegia occurs after cardiac surgery, it can lower the blood pressure to dangerous levels, which can lead to organ malfunction and may even be life-threatening. In order to maintain safety under such a situation, intensive care doctors administer drugs that tighten blood vessels. These drugs are called vasopressors. Such vasopressors can restore safe levels of blood pressure. However, they have significant side effects. Thus, it would be desirable to restore a safe blood pressure without the use of such vasopressor drugs. Over the last few years, evidence has emerged that high dose vitamin C injected into the blood stream can restore the normal tightness of blood vessels and is free of side effects. This makes treatment with vitamin C potentially desirable in cardiac surgery patients with vasoplegia. However, no studies have assessed whether vitamin C at high dose is effective in this setting. Thus, we propose to conduct a pilot study to test whether vitamin C at high dose can improve blood pressure and decrease the need for vasopressor drugs in patients with vasoplegia after cardiac surgery.
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Trial website
Not applicable
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Trial related presentations / publications
Nil
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Public notes
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Attachments [1]
1733
1733
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0
/AnzctrAttachments/373018-20170517 HREC17Austin162 May17 (FULL ETHICS APPROVAL).pdf
(Ethics approval)
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Attachments [2]
2376
2376
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/AnzctrAttachments/373018-20171206 HREC17Austin162 Dec17 (Ethics PA and PICF's).pdf
(Ethics approval)
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Contacts
Principal investigator
Name
75130
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Prof Rinaldo Bellomo
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Address
75130
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Department of Intensive Care
Austin Hospital
145 Studley Road
Heidelberg VIC 3084
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Country
75130
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Australia
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Phone
75130
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+61394965992
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Fax
75130
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+61394963932
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Email
75130
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[email protected]
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Contact person for public queries
Name
75131
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Glenn Eastwood
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Address
75131
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Department of Intensive Care
Austin Hospital
145 Studley Road
Heidelberg VIC 3084
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Country
75131
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Australia
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Phone
75131
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+61394964835
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Fax
75131
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+61394963932
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Email
75131
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[email protected]
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Contact person for scientific queries
Name
75132
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Rinaldo Bellomo
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Address
75132
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Department of Intensive Care
Austin Hospital
145 Studley Road
Heidelberg VIC 3084
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Country
75132
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Australia
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Phone
75132
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+61394965992
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Fax
75132
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+61394963932
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Email
75132
0
[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Dimensions AI
Understanding the rationale for parenteral ascorbate (vitamin C) during an acute inflammatory reaction: a biochemical perspective
2018
https://doi.org/10.1016/s1441-2772(23)00687-7
Embase
A Pilot, Double-Blind, Randomized, Controlled Trial of High-Dose Intravenous Vitamin C for Vasoplegia After Cardiac Surgery.
2020
https://dx.doi.org/10.1053/j.jvca.2019.08.034
N.B. These documents automatically identified may not have been verified by the study sponsor.
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