Critically ill patients often suffer from inflammation and oxidative stress, which is an imbalance between harmful free radicals and protective antioxidants. In worst case, this may result in tissue damage and organ failure. It turns out vitamin C is a powerful antioxidant with a therapeutic potential. According to a new systematic review article and meta-analysis, therapy with large quantities of intravenous vitamin C helps shorten the duration of the hospital stay for critically ill patients without any side effects.
Vitamin C (ascorbic acid) is an essential vitamin that plants and most animals can synthesize to meet their individual need. Humans, however, have lost this ability to evolution. Vitamin C is important for collagen and for our connective tissue, immune defense, and wound healing. The vitamin is also a powerful antioxidant that protects cells against oxidative stress and inflammation caused by free radicals.
Diseases such as sepsis, cancer, and complicated cases of coronavirus and influenza are characterized by oxidative stress and uncontrollable, systemic inflammation that causes damage to healthy tissue. Scientists have therefore had their focus on vitamin C as a possible source of therapy for critically ill patients. Over the past five years, many studies have been published but with widely different outcome.
Earlier and newer studies of intravenous vitamin C for critically ill patients
A study from 2014 (Fowler et al.) showed that vitamin C was able to lower the risk of organ failure in critically ill patients. However, another study (CITRIS-ALI) was unable to demonstrate an effect of vitamin C therapy on organ dysfunction, inflammation markers, or blood vessel damage. Still, there was less mortality after 28 days (29.8 percent) in the vitamin C group compared with the placebo group (46.3 percent.)
In a study of patients suffering from severe sepsis and septic shock (Marik et al.), a reduction in organ failure and mortality was observed among patients who got vitamin C. A study from 2016 (Zabel et al.) demonstrated that patients with septic shock who got vitamin C could get by on a lower vasopressor dose and shorter treatment time. A study from 2019 (Nakajima et al.) showed that supplementation with high quantities of vitamin C helps lower mortality in patients with severe burns.
Vitamin C therapy has been used as treatment for a number of different critical conditions among patients in intensive care. The scientists behind the new review article and meta-analysis wanted to look closer at 53 studies that included a total of 352.395 critically ill patients in order to assess vitamin C as a therapeutic agent. They also wanted to find out if the treatment had side effects such as kidney damage.
Trawling various databases for information, the scientists found the relevant published studies of intravenous vitamin C used to treat critically ill patients. After reviewing the information, they concluded that large doses of vitamin C given to critically ill patients help shorten the duration of their hospital stay. Also, it is relatively safe and without noteworthy adverse effects on kidney function. The new review article is published in Nutrients.
Dhan Bahadur Shresta et al. Vitamin C in Critically Ill patients: An Updates Systematic Review and Meta-analysis. Nutrients October 2021
Search for more information...