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Critical Care
Published in: Critical Care 1/2022

Open Access 01-12-2022 | Septicemia | Research

Vitamin C improves microvascular reactivity and peripheral tissue perfusion in septic shock patients

Authors: Jean-Rémi Lavillegrand, Lisa Raia, Tomas Urbina, Geoffroy Hariri, Paul Gabarre, Vincent Bonny, Naïke Bigé, Jean-Luc Baudel, Arnaud Bruneel, Thierry Dupre, Bertrand Guidet, Eric Maury, Hafid Ait-Oufella

Published in: Critical Care | Issue 1/2022

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Abstract

Background

Vitamin C has potential protective effects through antioxidant and anti-inflammatory properties. However, the effect of vitamin C supplementation on microvascular function and peripheral tissue perfusion in human sepsis remains unknown. We aimed to determine vitamin C effect on microvascular endothelial dysfunction and peripheral tissue perfusion in septic shock patients.

Methods

Patients with septic shock were prospectively included after initial resuscitation. Bedside peripheral tissue perfusion and skin microvascular reactivity in response to acetylcholine iontophoresis in the forearm area were measured before and 1 h after intravenous vitamin C supplementation (40 mg/kg). Norepinephrine dose was not modified during the studied period.

Results

We included 30 patients with septic shock. SOFA score was 11 [8–14], SAPS II was 66 [54–79], and in-hospital mortality was 33%. Half of these patients had vitamin C deficiency at inclusion. Vitamin C supplementation strongly improved microvascular reactivity (AUC 2263 [430–4246] vs 5362 [1744–10585] UI, p = 0.0004). In addition, vitamin C supplementation improved mottling score (p = 0.06), finger-tip (p = 0.0003) and knee capillary refill time (3.7 [2.6–5.5] vs 2.9 [1.9–4.7] s, p < 0.0001), as well as and central-to-periphery temperature gradient (6.1 [4.9–7.4] vs 4.6 [3.4–7.0] °C, p < 0.0001). The beneficial effects of vitamin C were observed both in patients with or without vitamin C deficiency.

Conclusion

In septic shock patients being resuscitated, vitamin C supplementation improved peripheral tissue perfusion and microvascular reactivity whatever plasma levels of vitamin C.
ClinicalTrials.gov Identifier: NCT04778605 registered 26 January 2021.
Appendix
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Metadata
Title
Vitamin C improves microvascular reactivity and peripheral tissue perfusion in septic shock patients
Authors
Jean-Rémi Lavillegrand
Lisa Raia
Tomas Urbina
Geoffroy Hariri
Paul Gabarre
Vincent Bonny
Naïke Bigé
Jean-Luc Baudel
Arnaud Bruneel
Thierry Dupre
Bertrand Guidet
Eric Maury
Hafid Ait-Oufella
Publication date
01-12-2022
Publisher
BioMed Central
Published in
Critical Care / Issue 1/2022
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/s13054-022-03891-8

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