Journal of Surgery Concepts & Practice >

2023 , Vol. 28 >Issue 05: 437 - 440

DOI: https://doi.org/10.16139/j.1007-9610.2023.05.08

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Application of high dose intravenous vitamin C in critical cared diseases

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  • Department of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China

Received date: 2023-07-28

  Online published: 2024-01-04

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Abstract

Vitamin C is an essential micronutrient for human and its deficiency will lead to scurvy. In recent years, as a new therapeutic strategy, high dose intravenous vitamin C(HDIVC) has been widely studied in critical cared diseases. In this review, we summarized the progress of HDIVC in sepsis, including its research history, rationality of usage, controversy and prospect, problems and outlook. The application of HDIVC in critical cared diseases underwent three periods: early, preheating and outbreaking period. Given the reduction of vitamin C in critical diseases, it requires rapid intravenous supplementation. We confirmed the therapeutic efficacy of HDIVC in COVID-19 and severe acute pancreatitis respectively. It is well known that HDIVC has effect of suppressing inflammatory responses, stabilizing the circulation and improving the immunity. But the application of HDIVC in critical cared diseases is still controversial, for the opposing findings in multiple large-scale randomized controlled trials. Future studies should be better to pay further attention on the dose and time of vitamin C and vitamin C plasma concentration monitoring.

Key words： Vitamin C; High dose intravenous vitamin C(HDIVC); Critical cared disease

Cite this article

ZHAO Bing, YU Xianxian, MAO Enqiang . Application of high dose intravenous vitamin C in critical cared diseases[J]. Journal of Surgery Concepts & Practice, 2023 , 28(05) : 437 -440 . DOI: 10.16139/j.1007-9610.2023.05.08

References

[1] DRESEN E, LEE Z Y, HILL A, et al. History of scurvy and use of Vitamin C,in critical illness: a narrative review[J]. Nutr Clin Pract, 2023, 38(1):46-54.
[2] OUDEMANS-VAN STRAATEN H M, SPOELSTRA-DE MAN A M, DE WAARD M C. Vitamin C revisited[J]. Crit Care, 2014, 18(4):460.
[3] CERULLO G, NEGRO M, PARIMBELLI M, et al. The long history of vitamin C: from prevention of the common cold to potential aid in the treatment of COVID-19[J]. Front Immunol, 2020, 11:574029.
[4] KIM T K, LIM H R, BYUN J S. Vitamin C supplementation reduces the odds of developing a common cold in Republic of Korea Army recruits: randomised controlled trial[J]. BMJ Mil Health, 2022, 168(2):117-123.
[5] MARIK P E, KHANGOORA V, RIVERA R, et al. Hydrocortisone, vitamin C, and thiamine for the treatment of severe sepsis and septic shock a retrospective before-after study[J]. Chest, 2017, 151(6):1229-1238.
[6] HOLFORD P, CARR A C, JOVIC T H, et al. Vitamin C-an adjunctive therapy for respiratory infection, sepsis and COVID-19[J]. Nutrients, 2020, 12(12):3760.
[7] LIU F, ZHU Y, ZHANG J, et al. Intravenous high-dose vitamin C for the treatment of severe COVID-19: study protocol for a multicentre randomised controlled trial[J]. BMJ Open, 2020, 10(7):e039519.
[8] MASSE M H, MéNARD J, SPRAGUE S, et al. Lessening Organ dysfunction with VITamin C (LOVIT): protocol for a randomized controlled trial[J]. Trials, 2020, 21(1):42.
[9] FOWLER A A 3rd, TRUWIT J D, HITE RD, et al. Effect of vitamin C infusion on organ failure and biomarkers of inflammation and vascular injury in patients with sepsis and severe acute respiratory failure: the CITRIS-ALI randomized clinical trial[J]. JAMA, 2019, 322(13):1261-1270.
[10] LEE Z Y, ORTIZ-REYES L, LEW C C H, et al. Intravenous vitamin C monotherapy in critically ill patients: a systematic review and meta-analysis of randomized controlled trials with trial sequential analysis[J]. Ann Intensive Care, 2023, 13(1):14.
[11] HEMILA H, CHALKER E. Vitamin C may reduce the duration of mechanical ventilation in critically ill patients: a meta-regression analysis[J]. J Intensive Care, 2020, 8(1):15.
[12] HEMILA H, CHALKER E. Vitamin C can shorten the length of stay in the ICU: a meta-analysis[J]. Nutrients, 2019, 11(4):708.
[13] ZHAO B, LING Y, LI J, et al. Beneficial aspects of high dose intravenous vitamin C on patients with COVID-19 pneumonia in severe condition: a retrospective case series study[J]. Ann Palliat Med, 2021, 10(2):1599-1609.
[14] ZHAO B, LIU M, LIU P, et al. High dose intravenous vitamin C for preventing the disease aggravation of moderate COVID-19 pneumonia. A retrospective propensity matched before-after study[J]. Front Pharmacol, 2021, 12:638556.
[15] DOSEDEL M, JIRKOVSKY E, MACáKOVá K, et al. Vitamin C-sources, physiological role, kinetics, deficiency, use, toxicity, and determination[J]. Nutrients, 2021, 13(2):615.
[16] QI M Z, YAO Y, XIE R L, et al. Intravenous vitamin C attenuates hemorrhagic shock-related renal injury through the induction of SIRT1 in rats[J]. Biochem Biophys Res Commun, 2018, 501(2):358-364.
[17] CARR A C, MAGGINI S. Vitamin C and immune function[J]. Nutrients, 2017, 9(11):1211.
[18] LAMONTAGNE F, MASSE M H, MENARD J, et al. Intravenous vitamin C in adults with sepsis in the intensive care unit[J]. N Engl J Med, 2022, 386(25):2387-2398.
[19] HEMIL? H, CHALKER E. Abrupt termination of vitamin C from ICU patients may increase mortality: secondary analysis of the LOVIT trial[J]. Eur J Clin Nutr, 2023, 77(4):490-494.
[20] RADKE D I, HOMAYR A L, STOPPE C, et al. Vitamin C in critical illness: end of the story or still a place?[J]. Curr Opin Crit Care, 2023, 29(4):339-345.
[21] WACKER D A, BURTON S L, BERGER J P, et al. Evaluating vitamin C in septic shock: a randomized controlled trial of vitamin c monotherapy[J]. Crit Care Med, 2022, 50(5):e458-e467.
[22] ANAND T, ROLLER L K, JURKOVICH G J. Vitamin C in surgical sepsis[J]. Curr Opin Crit Care, 2019, 25(6):712-716.
[23] JUNG S Y, LEE M T, BAEK M S, et al. Vitamin C for?≥?5 days is associated with decreased hospital mortality in sepsis subgroups: a nationwide cohort study[J]. Crit Care, 2022, 26(1):3.
[24] ZABET M H, MOHAMMADI M, RAMEZANI M, et al. Effect of high-dose ascorbic acid on vasopressor's requirement in septic shock[J]. J Res Pharm Pract, 2016, 5(2):94-100.
[25] L LANGLOIS P, LAMONTAGNE F. Vitamin C for the critically ill: is the evidence strongenough?[J]. Nutrition, 2019, 60:185-190.
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