Mortality in septic patients treated with vitamin C: a systematic meta-analysis

Scholz SS, Borgstedt R, Ebeling N, Menzel LC, Jansen G, Rehberg S (2021)
Critical Care 25(1): 17.

Zeitschriftenaufsatz | Veröffentlicht | Englisch
 
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Autor*in
Scholz, Sean S.; Borgstedt, Rainer; Ebeling, Nicole; Menzel, Leoni C.; Jansen, Gerrit; Rehberg, SebastianUniBi
Abstract / Bemerkung
BackgroundSupplementation of vitamin C in septic patients remains controversial despite eight large clinical trials published only in 2020. We aimed to evaluate the evidence on potential effects of vitamin C treatment on mortality in adult septic patients.MethodsData search included PubMed, Web of Science, and the Cochrane Library. A meta-analysis of eligible peer-reviewed studies was performed in accordance with the PRISMA statement. Only studies with valid classifications of sepsis and intravenous vitamin C treatment (alone or combined with hydrocortisone/thiamine) were included.ResultsA total of 17 studies including 3133 patients fulfilled the predefined criteria and were analyzed. Pooled analysis indicated no mortality reduction in patients treated with vitamin C when compared to reference (risk difference - 0.05 [95% CI - 0.11 to - 0.01]; p=0.08; p for Cochran Q=0.002; I-2=56%). Notably, subgroup analyses revealed an improved survival, if vitamin C treatment was applied for 3-4 days (risk difference, - 0.10 [95% CI - 0.19 to - 0.02]; p=0.02) when compared to patients treated for 1-2 or >5 days. Also, timing of the pooled mortality assessment indicated a reduction concerning short-term mortality (<30 days; risk difference, - 0.08 [95% CI - 0.15 to - 0.01]; p=0.02; p for Cochran Q=0.02; I-2=63%). Presence of statistical heterogeneity was noted with no sign of significant publication bias.ConclusionAlthough vitamin C administration did not reduce pooled mortality, patients may profit if vitamin C is administered over 3 to 4 days. Consequently, further research is needed to identify patient subgroups that might benefit from intravenous supplementation of vitamin C.
Stichworte
Ascorbic acid; Septic shock; Mortality; Sepsis
Erscheinungsjahr
2021
Zeitschriftentitel
Critical Care
Band
25
Ausgabe
1
Art.-Nr.
17
ISSN
1364-8535
eISSN
1466-609X
Page URI
https://pub.uni-bielefeld.de/record/2951304

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Scholz SS, Borgstedt R, Ebeling N, Menzel LC, Jansen G, Rehberg S. Mortality in septic patients treated with vitamin C: a systematic meta-analysis. Critical Care . 2021;25(1): 17.
Scholz, S. S., Borgstedt, R., Ebeling, N., Menzel, L. C., Jansen, G., & Rehberg, S. (2021). Mortality in septic patients treated with vitamin C: a systematic meta-analysis. Critical Care , 25(1), 17. https://doi.org/10.1186/s13054-020-03438-9
Scholz, S. S., Borgstedt, R., Ebeling, N., Menzel, L. C., Jansen, G., and Rehberg, S. (2021). Mortality in septic patients treated with vitamin C: a systematic meta-analysis. Critical Care 25:17.
Scholz, S.S., et al., 2021. Mortality in septic patients treated with vitamin C: a systematic meta-analysis. Critical Care , 25(1): 17.
S.S. Scholz, et al., “Mortality in septic patients treated with vitamin C: a systematic meta-analysis”, Critical Care , vol. 25, 2021, : 17.
Scholz, S.S., Borgstedt, R., Ebeling, N., Menzel, L.C., Jansen, G., Rehberg, S.: Mortality in septic patients treated with vitamin C: a systematic meta-analysis. Critical Care . 25, : 17 (2021).
Scholz, Sean S., Borgstedt, Rainer, Ebeling, Nicole, Menzel, Leoni C., Jansen, Gerrit, and Rehberg, Sebastian. “Mortality in septic patients treated with vitamin C: a systematic meta-analysis”. Critical Care 25.1 (2021): 17.

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