Mode
Text Size
Log in / Sign up

Intravenous Vitamin C Administration in Severe Burn Patients Shows Potential HarmTrial shows intravenous vitamin C may harm patients with severe burns

AI-generated summary of the cited source, checked by automated accuracy review. How we work

Key Takeaway
High-dose intravenous vitamin C is associated with increased mortality and organ dysfunction in severe burn patients.

This Phase 3 randomized clinical trial evaluated the efficacy and safety of high-dose intravenous vitamin C in patients with severe burns. The study enrolled 238 adults with deep second- or third-degree burns covering at least 20% of their total body surface area. These patients required skin grafting and were treated in 24 burn centers across multiple continents. The intervention consisted of 50 mg/kg of vitamin C administered every six hours for 96 hours, compared against a matched placebo.

The primary endpoint was a composite of 28-day mortality and persistent organ dysfunction, which included the need for mechanical ventilation, kidney replacement therapy, or vasopressor support at day 28. Results from the interim analysis indicated a higher incidence of this composite outcome in the treatment arm compared to the control. Specifically, the incidence was 40.8% for those receiving the vitamin, while the control group saw 29.7%. Although the p-value was 0.06, the trend suggested a potential risk rather than a benefit.

Secondary outcomes focused on the time to discharge alive from the hospital within 90 days. The data showed no significant difference between the two cohorts regarding discharge timelines. However, more concerning data emerged regarding specific mortality metrics. The 28-day mortality rate was significantly higher in the intervention group (15.0%) compared to the placebo group (7.6%), with a statistically significant adjusted risk ratio of 1.96 (P = 0.001).

Furthermore, the hospital mortality rate was also significantly higher in the group receiving vitamin C (23.3%) compared to the placebo group (16.1%). This finding was statistically significant with an adjusted risk ratio of 1.44 (P = 0.03). These findings suggest that the administration of high-dose vitamin C may be associated with poorer clinical outcomes in the acute phase of severe burn management.

Due to these concerning signals, the trial was stopped early following the first prespecified interim analysis for futility and harm. The data suggests that the intervention did not meet the primary endpoint and may have posed a risk to patient safety. Clinicians should exercise extreme caution when considering high-dose vitamin C as an adjunctive therapy for severe burns.

In conclusion, the trial provides evidence that high-dose intravenous vitamin C does not improve survival or organ function in severe burn patients. On the contrary, the data suggests a potential for increased mortality. These findings are critical for establishing evidence-based protocols in burn care units. The early termination of the trial underscores the importance of rigorous safety monitoring in phase 3 trials involving metabolic interventions.

How this fits prior evidence

How this fits prior evidence This finding contrasts with the previously reported finding that intravenous vitamin C was associated with reduced mortality in patients with sepsis and septic shock. While that earlier evidence was noted as being of low quality and lacking multicenter confirmation, this Phase 3 trial provides high-level evidence that intravenous vitamin C is associated with increased 28-day mortality (15.0% vs 7.6%) and increased hospital mortality (23.3% vs 16.1%) in patients with severe burns.

For people who suffer from severe burns, the first few days of treatment are critical. These patients often face life-threatening complications, including organ failure and severe infections. Because of these risks, doctors have explored various ways to support the body during recovery. One area of interest has been the use of high-dose vitamin C to help the body fight stress and inflammation caused by major skin damage.

To test if this treatment was effective, researchers conducted a large-scale Phase 3 clinical trial. The study included 238 adults who had deep second-degree or third-degree burns covering at least 20 percent of their bodies. These patients were treated in 24 different burn centers across several continents, including North and South America, Europe, and Asia. The study was designed to see if giving vitamin C through an IV would improve survival rates or reduce the need for life-saving machines like ventilators or kidney replacement therapy.

The results of the trial were concerning. Patients who received the high-dose vitamin C were more likely to die within 28 days compared to those who received a placebo. Specifically, the mortality rate was 15 percent in the vitamin C group compared to 7.6 percent in the placebo group. Furthermore, the combination of death and persistent organ failure was higher in the group receiving vitamin C. The trial was actually stopped early by the researchers because the initial data suggested the treatment was not working and might even be harmful to the patients.

It is important to understand the limitations of these findings before drawing firm conclusions. Because the trial was stopped early, the data comes from an interim analysis rather than a completed study. While the results show a concerning link between vitamin juice and higher mortality, one study alone cannot change medical practice immediately. However, the fact that the trial was stopped for potential harm is a significant signal for doctors and researchers. For patients and families right now, this means that high-dose intravenous vitamin C is not currently recommended as a standard treatment for severe burns. While vitamin C is a common nutrient, giving it in very high doses through an IV during a major trauma is a specific medical intervention that carries risks. Doctors will continue to rely on established, proven treatments to manage burn injuries and support organ function during the critical recovery period.

What this means for you:
A large trial suggests high-dose vitamin C may increase mortality in severe burn patients and was stopped early.

Study Details

Study typeRct
Sample sizen = 238
EvidenceLevel 2
Follow-up216.0 mo
PublishedSep 2026
View Original Abstract ↓
IMPORTANCE: Severe burn injury triggers systemic inflammation that can lead to multiple organ dysfunctions and death. High-dose intravenous vitamin C has been proposed to mitigate these effects, but strong evidence in patients with burn injury is lacking. OBJECTIVE: To evaluate the efficacy of high-dose intravenous vitamin C in patients with severe burn injury. DESIGN, SETTING, AND PARTICIPANTS: Randomized, double-blind, placebo-controlled phase 3 trial conducted across 24 burn centers in North, Central, and South America; Europe; and Asia. Adults (≥18 years) with deep second- and/or third-degree burns covering 20% or more of total body surface area and requiring skin grafting were enrolled between August 18, 2020, and September 12, 2025. Final follow-up was completed in March 2026. The trial was stopped early after the first prespecified interim analysis for futility/harm. INTERVENTIONS: Patients were randomly assigned (1:1) to receive intravenous vitamin C (50 mg/kg every 6 hours for 96 hours) or matched placebo. MAIN OUTCOMES AND MEASURES: The primary outcome was a composite of 28-day mortality and persistent organ dysfunction (defined as dependence on mechanical ventilation, kidney replacement therapy, or vasopressor/inotrope support at day 28). The main secondary outcome was time to discharge alive from hospital within 90 days. RESULTS: Among 238 patients enrolled (mean age, 48.9 [SD, 19.1] years; 79% male; mean total body surface area, 37.0% [SD, 14.6%]), 120 were assigned to vitamin C and 118 to placebo. The primary composite outcome occurred in 49 patients (40.8%) in the vitamin C group and 35 patients (29.7%) in the placebo group (adjusted risk ratio [RR], 1.28 [95% CI, 0.99-1.65]; P = .06), crossing the prespecified futility/harm threshold and prompting early trial termination. Time to discharge alive from hospital within 90 days was not improved (adjusted subdistribution hazard ratio, 0.85 [95% CI, 0.62-1.16]; P = .31). Twenty-eight-day mortality was higher in the vitamin C group (15.0% vs 7.6%; adjusted RR, 1.96 [95% CI, 1.32-2.90]; P = .001), as was hospital mortality (23.3% vs 16.1%; adjusted RR, 1.44 [95% CI, 1.03-2.00]; P = .03). CONCLUSIONS AND RELEVANCE: Among patients with severe burn injury, high-dose intravenous vitamin C did not reduce 28-day mortality and persistent organ dysfunction and is possibly harmful. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04138394.
Free Newsletter

Clinical research that matters. Delivered to your inbox.

Join thousands of clinicians and researchers. No spam, unsubscribe anytime.