Vitamin C reduces mortality, ICU stay in sepsis
According to a new study, Vitamin C reduces mortality, ICU stay and shorter duration of vasopressor use in patients with sepsis.
Severe sepsis and Septic shock is the leading cause of death in the intensive care unit (ICUs). Also, vitamin C is known to beneficial for patients with septic shock due to its Bactericidal and bacteriostatic nature. However, a new study presented at the CHEST Annual Meeting 2018 in San Antonio, Texas finds that there is a low-quality strong evidence that vitamin C treatment is associated with significantly lower mortality rates, shorter lengths of intensive care unit (ICU) stay, and shorter duration of vasopressor use in patients with sepsis.
Antioxidant properties of vitamin C are known to improve microvascular integrity and prevent endothelial damage. It is also a cofactor in the synthesis of catecholamines.
Given these known properties and effects, researchers conducted a meta-analysis to gather more supporting data regarding the use of vitamin C in patients with sepsis.
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The meta-analysis involved 3 studies 2 of which were randomized and 1 of which was retrospective, consisting of total 138 patients, 69 of whom received Vit. C. These studies were found by conducting a systematic search of the Cochrane Library, PubMed, and Scopus for relevant articles published up to January 2018. The researchers then used either random or fixed effects models based on heterogeneity and the Mental-Haenszel method for analysis. Heterogeneity <30% was considered low, ≥30% to 60% was considered moderate, and >60% was considered substantial. A random model was used for heterogeneity >60%.
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- Mortality rates were significantly lower in the patients in the vitamin C group (13% vs 47.8%; odds ratio 0.15; 95% CI, 0.06-0.36; P <.001; I2=0%).
- Vitamin C was also associated with significantly lower ICU stay lengths — a mean difference of 1.49 days fewer (95% CI, -1.94 to -1.04; P <.00001; I2=0%) — and a mean difference of 30.22 fewer hours of vasopressor use (95% CI, -44.47 to -15.98; P <.0001; I2=69%)
The researchers affirmed that the study results were encouraging, however, there was no clear evidence regarding the optimal duration of vitamin C treatment or the recommended dosage. The study also significantly lacked scope, in that it examined only 138 patients in 3 studies, suggesting there is a need for a much larger study of higher quality evidence.
Ultimately, the researchers “do not recommend the routine use of vitamin C in patients with severe sepsis and septic shock.” Additional studies are required to confirm these preliminary findings.
For further reference log on to :
Velagapudi RK, Upadhaya S, Aburahma A, Bachuwa G. Use of vitamin C in patients with sepsis is associated with lower mortality: a meta-analysis. Presented at: CHEST Annual Meeting 2018; October 6-10, 2018; San Antonio, TX.