Cargando…

Vitamin C may reduce the duration of mechanical ventilation in critically ill patients: a meta-regression analysis

BACKGROUND: Our recent meta-analysis indicated that vitamin C may shorten the length of ICU stay and the duration of mechanical ventilation. Here we analyze modification of the vitamin C effect on ventilation time, by the control group ventilation time (which we used as a proxy for severity of disea...

Descripción completa

Detalles Bibliográficos
Autores principales: Hemilä, Harri, Chalker, Elizabeth
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7006137/
https://www.ncbi.nlm.nih.gov/pubmed/32047636
http://dx.doi.org/10.1186/s40560-020-0432-y
_version_ 1783495080573665280
author Hemilä, Harri
Chalker, Elizabeth
author_facet Hemilä, Harri
Chalker, Elizabeth
author_sort Hemilä, Harri
collection PubMed
description BACKGROUND: Our recent meta-analysis indicated that vitamin C may shorten the length of ICU stay and the duration of mechanical ventilation. Here we analyze modification of the vitamin C effect on ventilation time, by the control group ventilation time (which we used as a proxy for severity of disease in the patients of each trial). METHODS: We searched MEDLINE, Scopus, and the Cochrane Central Register of Controlled Trials and reference lists of relevant publications. We included controlled trials in which the administration of vitamin C was the only difference between the study groups. We did not limit our search to randomized trials and did not require placebo control. We included all doses and all durations of vitamin C administration. One author extracted study characteristics and outcomes from the trial reports and entered the data in a spreadsheet. Both authors checked the data entered against the original reports. We used meta-regression to examine whether the vitamin C effect on ventilation time depends on the duration of ventilation in the control group. RESULTS: We identified nine potentially eligible trials, eight of which were included in the meta-analysis. We pooled the results of the eight trials, including 685 patients in total, and found that vitamin C shortened the length of mechanical ventilation on average by 14% (P = 0.00001). However, there was significant heterogeneity in the effect of vitamin C between the trials. Heterogeneity was fully explained by the ventilation time in the untreated control group. Vitamin C was most beneficial for patients with the longest ventilation, corresponding to the most severely ill patients. In five trials including 471 patients requiring ventilation for over 10 h, a dosage of 1–6 g/day of vitamin C shortened ventilation time on average by 25% (P < 0.0001). CONCLUSIONS: We found strong evidence that vitamin C shortens the duration of mechanical ventilation, but the magnitude of the effect seems to depend on the duration of ventilation in the untreated control group. The level of baseline illness severity should be considered in further research. Different doses should be compared directly in future trials.
format Online
Article
Text
id pubmed-7006137
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-70061372020-02-11 Vitamin C may reduce the duration of mechanical ventilation in critically ill patients: a meta-regression analysis Hemilä, Harri Chalker, Elizabeth J Intensive Care Research BACKGROUND: Our recent meta-analysis indicated that vitamin C may shorten the length of ICU stay and the duration of mechanical ventilation. Here we analyze modification of the vitamin C effect on ventilation time, by the control group ventilation time (which we used as a proxy for severity of disease in the patients of each trial). METHODS: We searched MEDLINE, Scopus, and the Cochrane Central Register of Controlled Trials and reference lists of relevant publications. We included controlled trials in which the administration of vitamin C was the only difference between the study groups. We did not limit our search to randomized trials and did not require placebo control. We included all doses and all durations of vitamin C administration. One author extracted study characteristics and outcomes from the trial reports and entered the data in a spreadsheet. Both authors checked the data entered against the original reports. We used meta-regression to examine whether the vitamin C effect on ventilation time depends on the duration of ventilation in the control group. RESULTS: We identified nine potentially eligible trials, eight of which were included in the meta-analysis. We pooled the results of the eight trials, including 685 patients in total, and found that vitamin C shortened the length of mechanical ventilation on average by 14% (P = 0.00001). However, there was significant heterogeneity in the effect of vitamin C between the trials. Heterogeneity was fully explained by the ventilation time in the untreated control group. Vitamin C was most beneficial for patients with the longest ventilation, corresponding to the most severely ill patients. In five trials including 471 patients requiring ventilation for over 10 h, a dosage of 1–6 g/day of vitamin C shortened ventilation time on average by 25% (P < 0.0001). CONCLUSIONS: We found strong evidence that vitamin C shortens the duration of mechanical ventilation, but the magnitude of the effect seems to depend on the duration of ventilation in the untreated control group. The level of baseline illness severity should be considered in further research. Different doses should be compared directly in future trials. BioMed Central 2020-02-07 /pmc/articles/PMC7006137/ /pubmed/32047636 http://dx.doi.org/10.1186/s40560-020-0432-y Text en © The Author(s). 2020 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Hemilä, Harri
Chalker, Elizabeth
Vitamin C may reduce the duration of mechanical ventilation in critically ill patients: a meta-regression analysis
title Vitamin C may reduce the duration of mechanical ventilation in critically ill patients: a meta-regression analysis
title_full Vitamin C may reduce the duration of mechanical ventilation in critically ill patients: a meta-regression analysis
title_fullStr Vitamin C may reduce the duration of mechanical ventilation in critically ill patients: a meta-regression analysis
title_full_unstemmed Vitamin C may reduce the duration of mechanical ventilation in critically ill patients: a meta-regression analysis
title_short Vitamin C may reduce the duration of mechanical ventilation in critically ill patients: a meta-regression analysis
title_sort vitamin c may reduce the duration of mechanical ventilation in critically ill patients: a meta-regression analysis
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7006137/
https://www.ncbi.nlm.nih.gov/pubmed/32047636
http://dx.doi.org/10.1186/s40560-020-0432-y
work_keys_str_mv AT hemilaharri vitamincmayreducethedurationofmechanicalventilationincriticallyillpatientsametaregressionanalysis
AT chalkerelizabeth vitamincmayreducethedurationofmechanicalventilationincriticallyillpatientsametaregressionanalysis