Cargando…

A Systematic Review and Meta-Analysis on Possible Role of Vitamin C in Sepsis

Sepsis is a substantial healthcare burden, and its management continues to be a major challenge. Prior studies demonstrate conflicting evidence regarding the utility of vitamin C in sepsis. This systematic review and meta-analysis aim to collect data among critically ill patients (sepsis/septic shoc...

Descripción completa

Detalles Bibliográficos
Autores principales: Brown, Jonathan, Robertson, Cassie, Sevilla, Luis, Garza, Jorge, Rashid, Hytham, Benitez, Ana C, Shipotko, Mikhail, Ali, Zuhair
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9867929/
https://www.ncbi.nlm.nih.gov/pubmed/36699754
http://dx.doi.org/10.7759/cureus.32886
_version_ 1784876441673924608
author Brown, Jonathan
Robertson, Cassie
Sevilla, Luis
Garza, Jorge
Rashid, Hytham
Benitez, Ana C
Shipotko, Mikhail
Ali, Zuhair
author_facet Brown, Jonathan
Robertson, Cassie
Sevilla, Luis
Garza, Jorge
Rashid, Hytham
Benitez, Ana C
Shipotko, Mikhail
Ali, Zuhair
author_sort Brown, Jonathan
collection PubMed
description Sepsis is a substantial healthcare burden, and its management continues to be a major challenge. Prior studies demonstrate conflicting evidence regarding the utility of vitamin C in sepsis. This systematic review and meta-analysis aim to collect data among critically ill patients (sepsis/septic shock), comparing the efficacy of parenteral vitamin C with standard care. A literature review was conducted using databases including PubMed, Web of Science, Google Scholar, and the Cochrane Library to identify randomized controlled trials (RCTs) and observational studies comparing intravenous vitamin C alone or in combination with thiamine or glucocorticoids to the standard of care. We identified 11 RCTs and seven retrospective cohort studies. The primary outcome was 28-day mortality. Secondary outcomes included intensive care unit (ICU) length of stay, change in Sequential Organ Failure Assessment (SOFA) score, duration of vasopressor use, and duration of mechanical ventilation. A total of 18 studies with 4078 patients were included in our final analysis. Overall, we found no mortality reduction in patients treated with vitamin C compared to standard of care (odds ratio (OR) 0.92; 95% confidence interval (CI) 0.78 to 1.09; p = 0.34). Studies that reported a change in SOFA scores, ICU length of stay, duration of mechanical ventilation, or duration of vasopressor use did not show any significant difference between groups. Subgroup analysis with RCT versus observational studies and vitamin C dosage regimens did not show any difference. Among patients with sepsis or septic shock, treatment with vitamin C was not associated with a reduction in mortality, ICU length of stay, change in SOFA score, duration of vasopressor use, or duration of mechanical ventilation. Further studies are needed to demonstrate the potential role of vitamin C in the management of sepsis.
format Online
Article
Text
id pubmed-9867929
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Cureus
record_format MEDLINE/PubMed
spelling pubmed-98679292023-01-24 A Systematic Review and Meta-Analysis on Possible Role of Vitamin C in Sepsis Brown, Jonathan Robertson, Cassie Sevilla, Luis Garza, Jorge Rashid, Hytham Benitez, Ana C Shipotko, Mikhail Ali, Zuhair Cureus Internal Medicine Sepsis is a substantial healthcare burden, and its management continues to be a major challenge. Prior studies demonstrate conflicting evidence regarding the utility of vitamin C in sepsis. This systematic review and meta-analysis aim to collect data among critically ill patients (sepsis/septic shock), comparing the efficacy of parenteral vitamin C with standard care. A literature review was conducted using databases including PubMed, Web of Science, Google Scholar, and the Cochrane Library to identify randomized controlled trials (RCTs) and observational studies comparing intravenous vitamin C alone or in combination with thiamine or glucocorticoids to the standard of care. We identified 11 RCTs and seven retrospective cohort studies. The primary outcome was 28-day mortality. Secondary outcomes included intensive care unit (ICU) length of stay, change in Sequential Organ Failure Assessment (SOFA) score, duration of vasopressor use, and duration of mechanical ventilation. A total of 18 studies with 4078 patients were included in our final analysis. Overall, we found no mortality reduction in patients treated with vitamin C compared to standard of care (odds ratio (OR) 0.92; 95% confidence interval (CI) 0.78 to 1.09; p = 0.34). Studies that reported a change in SOFA scores, ICU length of stay, duration of mechanical ventilation, or duration of vasopressor use did not show any significant difference between groups. Subgroup analysis with RCT versus observational studies and vitamin C dosage regimens did not show any difference. Among patients with sepsis or septic shock, treatment with vitamin C was not associated with a reduction in mortality, ICU length of stay, change in SOFA score, duration of vasopressor use, or duration of mechanical ventilation. Further studies are needed to demonstrate the potential role of vitamin C in the management of sepsis. Cureus 2022-12-23 /pmc/articles/PMC9867929/ /pubmed/36699754 http://dx.doi.org/10.7759/cureus.32886 Text en Copyright © 2022, Brown et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Internal Medicine
Brown, Jonathan
Robertson, Cassie
Sevilla, Luis
Garza, Jorge
Rashid, Hytham
Benitez, Ana C
Shipotko, Mikhail
Ali, Zuhair
A Systematic Review and Meta-Analysis on Possible Role of Vitamin C in Sepsis
title A Systematic Review and Meta-Analysis on Possible Role of Vitamin C in Sepsis
title_full A Systematic Review and Meta-Analysis on Possible Role of Vitamin C in Sepsis
title_fullStr A Systematic Review and Meta-Analysis on Possible Role of Vitamin C in Sepsis
title_full_unstemmed A Systematic Review and Meta-Analysis on Possible Role of Vitamin C in Sepsis
title_short A Systematic Review and Meta-Analysis on Possible Role of Vitamin C in Sepsis
title_sort systematic review and meta-analysis on possible role of vitamin c in sepsis
topic Internal Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9867929/
https://www.ncbi.nlm.nih.gov/pubmed/36699754
http://dx.doi.org/10.7759/cureus.32886
work_keys_str_mv AT brownjonathan asystematicreviewandmetaanalysisonpossibleroleofvitamincinsepsis
AT robertsoncassie asystematicreviewandmetaanalysisonpossibleroleofvitamincinsepsis
AT sevillaluis asystematicreviewandmetaanalysisonpossibleroleofvitamincinsepsis
AT garzajorge asystematicreviewandmetaanalysisonpossibleroleofvitamincinsepsis
AT rashidhytham asystematicreviewandmetaanalysisonpossibleroleofvitamincinsepsis
AT benitezanac asystematicreviewandmetaanalysisonpossibleroleofvitamincinsepsis
AT shipotkomikhail asystematicreviewandmetaanalysisonpossibleroleofvitamincinsepsis
AT alizuhair asystematicreviewandmetaanalysisonpossibleroleofvitamincinsepsis
AT brownjonathan systematicreviewandmetaanalysisonpossibleroleofvitamincinsepsis
AT robertsoncassie systematicreviewandmetaanalysisonpossibleroleofvitamincinsepsis
AT sevillaluis systematicreviewandmetaanalysisonpossibleroleofvitamincinsepsis
AT garzajorge systematicreviewandmetaanalysisonpossibleroleofvitamincinsepsis
AT rashidhytham systematicreviewandmetaanalysisonpossibleroleofvitamincinsepsis
AT benitezanac systematicreviewandmetaanalysisonpossibleroleofvitamincinsepsis
AT shipotkomikhail systematicreviewandmetaanalysisonpossibleroleofvitamincinsepsis
AT alizuhair systematicreviewandmetaanalysisonpossibleroleofvitamincinsepsis