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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...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2022
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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 |
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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 |
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