In this PRISM Rounds episode, we break down the Phase 2b ASTER trial—a multicenter, randomized, placebo-controlled PETAL Network study testing high-dose IV vitamin C (ascorbate) in adults with suspected/confirmed infection plus shock and/or acute hypoxemic respiratory failure. We review trial design, why enrollment stopped early, the primary outcome (days alive and free of respiratory, renal, and circulatory organ support through day 28), and how to interpret secondary signals without over-reading an underpowered study.

Original article (free full text): https://www.chestcc.org/article/S2949-7884(25)00041-3/fulltext

PubMed: https://pubmed.ncbi.nlm.nih.gov/41574117/

DOI: https://doi.org/10.1016/j.chstcc.2025.100168

Keywords: sepsis, septic shock, ARDS, acute hypoxemic respiratory failure, vitamin C, ascorbate, PETAL Network, randomized trial, organ support–free days, ICU outcomes, vasopressors, mechanical ventilation, renal replacement therapy, biomarkers, sTNFR1, evidence-based medicine, critical care journal club