Effect of vitamin C in critically ill patients with sepsis and septic shock: A meta-analysis
What this study found
Pooled randomized evidence suggests adjunct vitamin C improved key outcomes in critically ill patients with sepsis or septic shock. Compared with placebo, vitamin C reduced 28-day mortality and lowered vasopressor dose, while ICU length of stay did not differ. Overall, the review supports a potential survival and hemodynamic benefit for vitamin C in this setting.
- Study & population
- Systematic review and meta-analysis of nine randomized controlled trials in adult critically ill patients with sepsis or septic shock.
- Intervention
- Vitamin C was administered mainly intravenously as adjunct therapy, but dosing and duration varied widely across the included trials.
- Key limitation
- The evidence base was small, with only nine RCTs and substantial variation in dose, route, and treatment duration across studies.
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Open PDFOriginal abstract
The objective of this study was to investigate the efficacy of vitamin C in patients experiencing sepsis and septic shock. The PubMed, Embase and Cochrane Library databases were searched for randomized controlled trials (RCTs) about vitamin C treatments for critically ill patients suffering from sepsis and septic shock from inception until December 31, 2019. The primary outcome was mortality, and the secondary outcomes were the ICU length of stay and the dose of vasopressors. A meta-analysis of nine RCTs with a total of 584 patients (301 in the intervention group and 283 in the control group) was conducted. There were significant differences between the vitamin C group and the control group in 28-day mortality (fixed effects OR = 0.60 95% CI [0.42, 0.85], p = 0.004) and in the dose of vasopressors (SMD = −0.88 95% CI [−1.48, −0.29], p = 0.003); however, the ICU length of stay was the same between the two groups (SMD = −0.33 95% CI [−0.87, 0.20] p = 0.23). This meta-analysis demonstrated that the use of vitamin C (compared with placebo) led to a reduction in ICU mortality and a reduction in the dose of vasopressors in patients with septic shock. However, the ICU length of stay was not significantly different between the two groups. Therefore, multicentre and high-quality RCTs are needed to further clarify the safety and effectiveness of vitamin C among patients with sepsis and septic shock.