High-Dose Vitamin C Could Pose Risk in Severe Burns
Overview
The VICTORY trial found that high-dose intravenous vitamin C did not reduce mortality or persistent organ dysfunction in patients with severe burn injuries. The trial was terminated early due to findings suggesting potential harm associated with vitamin C treatment.
Background
Severe burn injuries can lead to significant morbidity and mortality, necessitating effective treatment strategies. High-dose vitamin C has been proposed as a potential therapy, but prior studies have yielded inconsistent results. The VICTORY trial aimed to provide definitive evidence regarding the efficacy and safety of high-dose vitamin C in this patient population.
Data Highlights
| Outcome | Vitamin C Group | Placebo Group |
|---|---|---|
| 28-day mortality | 15% | 8% |
| Hospital mortality | 23% | 16% |
| ICU mortality | 23% | 15% |
| 6-month mortality | 26% | 20% |
| Cumulative incidence of discharge alive by 90 days | 66% | 71% |
Key Findings
- High-dose vitamin C did not reduce the primary composite outcome of 28-day mortality or persistent organ dysfunction.
- The trial was terminated early after crossing a futility/harm threshold.
- 28-day mortality was higher in the vitamin C group (15%) compared to placebo (8%).
- Kidney replacement therapy was initiated in 11% of patients receiving vitamin C versus 6% in the placebo group.
- No benefit was observed in any prespecified subgroup analysis.
- Previous studies suggesting benefits were generally small and underpowered for significant outcomes.
Clinical Implications
The findings from the VICTORY trial indicate that high-dose intravenous vitamin C should not be used as a treatment for severe burn injuries due to lack of efficacy and potential harm.
Conclusion
The VICTORY trial provides evidence against the use of high-dose vitamin C in severe burn patients.
Related Resources & Content
- High-Dose Intravenous Vitamin C and Mortality and Organ Dysfunction in Severe Burn Injury: The VICTORY Randomized Clinical Trial, JAMA, 2026 -- https://jamanetwork.com/journals/jama/fullarticle/2850392?resultClick=1
- High-Dose Vitamin C in Burns: Time to Stop, JAMA, 2026 -- https://jamanetwork.com/journals/jama/fullarticle/2850393?resultClick=1
- American Burn Association’s Clinical Practice Guideline on Burn Shock Resuscitation, 2024 -- https://guidance.nattrauma.org/media/wetjtmrg/american-burn-association-clinical-practice-guidelines-on-burn-shock-resuscitation.pdf
- Intensive Care Medicine — Adjuvant Vitamin Supplementation in Critically Ill Patients: Emphasis on Thiamine, Vitamin C, and Vitamin D
- Contact Lens Spectrum — ONLINE PHOTO DIAGNOSIS
- Frontiers in Medicine — Polymyxin B-induced acute kidney injury in a burn patient: a case report and pharmaceutical care
- Critical Care (Springer) — Beyond diabetes: harnessing the power of metformin in burn care
- https://guidance.nattrauma.org/media/wetjtmrg/american-burn-association-clinical-practice-guidelines-on-burn-shock-resuscitation.pdf
- High-Dose Intravenous Vitamin C and Mortality and Organ Dysfunction in Severe Burn Injury: The VICTORY Randomized Clinical Trial | Trials | JAMA | JAMA Network
- High-Dose Vitamin C in Burns: Time to Stop | Trauma and Injury | JAMA | JAMA Network
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