Ascorbic Acid (Vitamin C — High-dose Burns)

How it works

As an antioxidant it scavenges reactive oxygen species generated after thermal injury, reducing microvascular permeability and capillary leak that drive burns oedema.

Prescribing in practice

• High-dose vitamin C is contraindicated or used with great caution in patients with glucose-6-phosphate dehydrogenase deficiency because it can precipitate acute haemolysis.
• Very high doses increase urinary oxalate and pose a risk of oxalate nephropathy and acute kidney injury, particularly with pre-existing renal impairment.
• It can interfere with point-of-care glucometer readings, potentially causing spurious values that mislead insulin dosing.

Monitoring

Monitor renal function, urine output, acid-base status, and the reliability of bedside glucose measurements during the infusion period.

Counselling the patient

• This is given as part of the early intensive resuscitation of a major burn.
• The team will watch kidney function and glucose readings closely while it is running.

Evidence & guidelines

High-dose vitamin C in burns resuscitation is supported by small studies suggesting reduced fluid requirements, but evidence remains limited and its use varies between burns centres.