Medicina (Mar 2024)

Intravenous Vitamin C as an Add-on Therapy for the Treatment of Sepsis in an Intensive Care Unit: A Prospective Cohort Study

  • Sergio Antonio Gonzalez-Vazquez,
  • Eli Efrain Gomez-Ramirez,
  • Laura Gonzalez-Lopez,
  • Jorge Ivan Gamez-Nava,
  • Juan Angel Peraza-Zaldivar,
  • Aline Priscilla Santiago-Garcia,
  • Melissa Ramirez-Villafaña,
  • Fabiola Gonzalez-Ponce,
  • Jose Jorge Gomez-Camarena,
  • Ana Miriam Saldaña-Cruz,
  • Norma Alejandra Rodriguez-Jimenez,
  • J. Ahuixotl Gutierrez-Aceves,
  • Adriana Jimenez-Lopez,
  • Sylvia Elena Totsuka-Sutto,
  • Ernesto German Cardona-Muñoz,
  • Juan Manuel Ponce-Guarneros

DOI
https://doi.org/10.3390/medicina60030464
Journal volume & issue
Vol. 60, no. 3
p. 464

Abstract

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Background and Objectives: According to the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3), sepsis is defined as “life-threatening organ dysfunction caused by a dysregulated host response to infection”. The increased presence of free radicals causes an increase in oxidative stress. Vitamin C is an essential water-soluble vitamin with antioxidant activity and immunoregulatory effects that plays a potential role in the treatment of bacterial infections. Our aim was to evaluate the effectiveness of adding vitamin C to the conventional treatment of sepsis to decrease its mortality rate. Materials and Methods: In a prospective cohort study, we included patients with a diagnosis of sepsis and a SOFA score ≥ 9 who were evaluated in an Intensive Care Unit at a secondary-care hospital. According to the intensive care specialist, they were treated using two different strategies: Group 1—patients with sepsis treated with conventional treatment without vitamin C; Group 2—patients with sepsis with the addition of vitamin C to conventional treatment. Results: We included 34 patients with sepsis. The incidence of mortality was 38%, and 47% of patients used vitamin C as an adjuvant to the basic treatment of sepsis. In the basal analyses, patients treated with use of vitamin C compared to patients treated without vitamin C required less use of glucocorticoids (75% vs. 100%, p = 0.039). At follow-up, patients treated without vitamin C had higher mortality than patients treated with vitamin C as an adjuvant for the treatment of sepsis (55.6% vs. 18.8%, p = 0.03). We observed that the use of vitamin C was a protective factor for mortality in patients with sepsis (RR: 0.54, 95% CI: 0.31–0.96, p = 0.03). Conclusions: The use of vitamin C as an adjuvant to treatment decreases the risk of mortality by 46% in patients with sepsis and SOFA ≥ 9 compared to patients treated without vitamin C as an adjuvant to sepsis.

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