IV vitamin C in critically Ill patients: A systematic review and meta-analysis

Patel, Jayshil J. and Ortiz-Reyes, Alfonso and Dhaliwal, Rupinder and Clarke, John and Hill, Aileen and Stoppe, Christian and Lee, Zheng-Yii and Heyland, Daren K. (2022) IV vitamin C in critically Ill patients: A systematic review and meta-analysis. Critical Care Medicine, 50 (3). E304-E312. ISSN 0090-3493, DOI https://doi.org/10.1097/CCM.0000000000005320.

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Abstract

OBJECTIVES: To conduct a systematic review and meta-analysis to evaluate the impact of IV vitamin C on outcomes in critically ill patients. DATA SOURCES: Systematic search of MEDLINE, EMBASE, CINAHL, and the Cochrane Register of Controlled Trials. STUDY SELECTION: Randomized controlled trials testing IV vitamin C in critically ill patients. Data Abstraction: Two independent reviewers abstracted patient characteristics, treatment details, and clinical outcomes. DATA SYNTHESIS: Fifteen studies involving 2,490 patients were identified. Compared with placebo, IV vitamin C administration is associated with a trend toward reduced overall mortality (relative risk, 0.87; 95% CI, 0.75-1.00; p = 0.06; test for heterogeneity I-2 = 6%). High-dose IV vitamin C was associated with a significant reduction in overall mortality (relative risk, 0.70; 95% CI, 0.52-0.96; p = 0.03), whereas low-dose IV vitamin C had no effect (relative risk, 0.94; 95% CI, 0.79-1.07; p = 0.46; test for subgroup differences, p = 0.14). IV vitamin C monotherapy was associated with a significant reduction in overall mortality (relative risk, 0.64; 95% CI, 0.49-0.83; p = 0.006), whereas there was no effect with IV vitamin C combined therapy. No trial reported an increase in adverse events related to IV vitamin C. CONCLUSIONS: IV vitamin C administration appears safe and may be associated with a trend toward reduction in overall mortality. High-dose IV vitamin C monotherapy may be associated with improved overall mortality, and further randomized controlled trials are warranted.

Item Type: Article
Funders: None
Uncontrolled Keywords: Ascorbic acid; Critical illness; Hydrocortisone; Mortality; Sepsis; Septic shock; Vitamin C
Subjects: R Medicine > RC Internal medicine
Divisions: Faculty of Medicine
Depositing User: Ms. Juhaida Abd Rahim
Date Deposited: 08 Aug 2022 08:38
Last Modified: 08 Aug 2022 08:38
URI: http://eprints.um.edu.my/id/eprint/33324

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