Group 1 will be treated with placebos for 4 days. All patients will receive Thiamine 200 mg q 12 hourly for 4 days to limit the conversion of vitamin C to oxalate

Group 2 will be treated with 1.5 gr Vitamin C b.i.d. (3 gr/day) for 4 days. All patients will receive Thiamine 200 mg q 12 hourly for 4 days to limit the conversion of vitamin C to oxalate

Group 3 will be treated with 5 gr Vitamin C b.i.d. (10 gr/day) for 4 days. All patients will receive Thiamine 200 mg q 12 hourly for 4 days to limit the conversion of vitamin C to oxalate

Cardiac Arrest

Vitamine C will be administered intravenously as ascorbic acid (ascorbinezuur CF 100 mg/ml, Centrafarm BV, Etten Leur, Netherlands).

Vitamin C

All patients will receive thiamine 200 mg q 12 hourly for 4 days to limit the conversion of vitamin C to oxalate.

Thiamine

Placebos

VU Medical Center

Vitamin C in Post-cardiac Arrest

Early High-dose Vitamin C in Post-cardiac Arrest Syndrome

ΔSOFA score is defined as the difference between SOFA admission and SOFA at 96 hours (46). Death at 96-hours will be counted as the maximum SOFA score (24 points).

Neurological outcome. The Glasgow Coma Scale (GCS) is the most common scoring system used to describe the level of consciousness. The GCS measures the following functions:
Eye opening (E): 4 = spontaneous, 3 = to sound, 2 = to pressure, 1 = none.
Verbal response (V): 5 = orientated, 4 = confused, 3 = words, but not coherent, 2 = sounds, but no words, 1 = none.
Motor response (M): 6 = obeys command, 5 = localizing, 4 = normal flexion, 3 = abnormal flexion, 2 = extension, 1 = none.

Neurological outcome after cardiac arrest. CPC 1: Good cerebral performance (normal life) CPC 2: Moderate cerebral disability (disability but independent) CPC 3: Severe cerebral disability (conscious but disabled and dependent) CPC 4: Coma or vegetative state (unconscious) CPC 5: Brain death

Neurological outcome. The modified Rankin Scale (mRS) is a commonly used scale for measuring the degree of disability or dependence in the daily activities of people who have suffered a stroke or other causes of neurological disability. The scale runs from 0-6, running from perfect health without symptoms to death.
0 - No symptoms.
- No significant disability. Able to carry out all usual activities, despite some symptoms.
- Slight disability. Able to look after own affairs without assistance, but unable to carry out all previous activities.
- Moderate disability. Requires some help, but able to walk unassisted.
- Moderately severe disability. Unable to attend to own bodily needs without assistance, and unable to walk unassisted.
- Severe disability. Requires constant nursing care and attention, bedridden, incontinent.
- Dead.

Neurological outcome. The Glasgow Outcome Scale (GOS) is a global scale for functional outcome that rates patient status into one of five categories: Dead, Vegetative State, Severe Disability, Moderate Disability or Good Recovery. The Extended GOS (GOSE) provides more detailed categorization into eight categories by subdividing the categories of severe disability, moderate disability and good recovery into a lower and upper category: the scale runs from 1-8.
Death
Vegetative state
Lower severe disability
Upper severe disability
Lower moderate disability
Upper moderate disability
Lower good recovery
Upper good recovery.

estimated Glomerular Filtration Rate (eGFR)

Angelique Spoelstra-de Man

M.D., Ph.D.

VU University Medical Center

Gelderse Vallei Hospital

Sint Franciscus Gasthuis

Tergooiziekenhuizen

Amphia Hospital

Erasmus Medical Center

Noordwest Ziekenhuisgroep

Maasstad Hospital

OLVG

In this multicentre, placebo controlled double-blind randomized clinical trial patients will be recruited from the Intensive Care Units of 8 hospitals.
270 comatose patients suffering an out-of-hospital cardiac arrest with ventricular fibrillation/tachycardia as first registered cardiac rhythm and EMV-score ≤8 will be included.
As soon as possible patients will be randomly allocated to one of 3 treatment groups of 90 patients each and vitamin C or placebo will be started for 96 hours. Group 1 will be treated with placebo, group 2 with 2 times a day a bolus of 1.5 gr vitamin C and group 3 with 2 times a day a bolus of 5 gr vitamin C.
All patients will receive thiamine 200 mg q 12 hourly for 4 days to limit the conversion of vitamin C to oxalate.

nephrocalcinosis/glutathione

Vitamin C in Post-cardiac Arrest

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