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Open Access 01-12-2021 | Septicemia | Research

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

Authors: Sean S. Scholz, Rainer Borgstedt, Nicole Ebeling, Leoni C. Menzel, Gerrit Jansen, Sebastian Rehberg

Published in: Critical Care | Issue 1/2021

Abstract

Background

Supplementation 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.

Methods

Data 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.

Results

A 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; I² = 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; I² = 63%). Presence of statistical heterogeneity was noted with no sign of significant publication bias.

Conclusion

Although 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.

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Title: Mortality in septic patients treated with vitamin C: a systematic meta-analysis
Authors: Sean S. Scholz
Rainer Borgstedt
Nicole Ebeling
Leoni C. Menzel
Gerrit Jansen
Sebastian Rehberg
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Septicemia
Septicemia
Septic Shock
Published in: Critical Care / Issue 1/2021
Electronic ISSN: 1364-8535
DOI: https://doi.org/10.1186/s13054-020-03438-9

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

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

Abstract

Background

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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