NEJM: Intravenous Vitamin C in Adults with Sepsis in the Intensive Care Unit

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Vitamin C is a water-soluble vitamin found in citrus and other fruits and vegetables, and also sold as a dietary supplement. It is used to prevent and treat scurvy. Vitamin C is an essential nutrient involved in the repair of tissue, the formation of collagen, and the enzymatic production of certain neurotransmitters. Wikipedia

Taking too much vitamin C can cause side effects, including:

  • Nausea, vomiting and diarrhea.
  • Heartburn.
  • Stomach cramps or bloating.
  • Fatigue and sleepiness, or sometimes insomnia.
  • Headache.
  • Skin flushing.

https://www.mayoclinic.org/drugs-supplements-vitamin-c/art-20363932

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The New England Journal of Medicine

Intravenous Vitamin C in Adults with Sepsis in the Intensive Care Unit

List of authors.

  • François Lamontagne, M.D.,
  • Marie-Hélène Masse, M.Sc.,
  • Julie Menard, Ph.D.,
  • Sheila Sprague, Ph.D.,
  • Ruxandra Pinto, Ph.D.,
  • Daren K. Heyland, M.D.,
  • Deborah J Cook, M.D.,
  • Marie-Claude Battista, Ph.D.,
  • Andrew G. Day, M.Sc.,
  • Gordon H. Guyatt, M.D.,
  • Salmaan Kanji, Pharm.D.,
  • Rachael Parke, R.N., M.H.Sc., Ph.D.,
  • Shay P. McGuinness, M.B., Ch.B.,
  • Bharath-Kumar Tirupakuzhi Vijayaraghavan, M.D.,
  • Djillali Annane, M.D., Ph.D.,
  • Dian Cohen, B.A.,
  • Yaseen M. Arabi, M.D.,
  • Brigitte Bolduc, M.Sc.,
  • Nicole Marinoff, R.N.,
  • Bram Rochwerg, M.D.,
  • Tina Millen, R.R.T.,
  • Maureen O. Meade, M.D.,
  • Lori Hand, B.Sc.,
  • Irene Watpool, R.N., B.Sc.N.,
  • Rebecca Porteous, B.N.Sc.,
  • Paul J. Young, M.B., Ch.B., Ph.D.,
  • Frederick D’Aragon, M.D.,
  • Emilie P. Belley-Cote, M.D., Ph.D.,
  • Elaine Carbonneau, R.N.,
  • France Clarke, R.R.T.,
  • David M. Maslove, M.D.,
  • Miranda Hunt, B.A.,
  • Michaël Chassé, M.D., Ph.D.,
  • Martine Lebrasseur, R.N.,
  • François Lauzier, M.D.,
  • Sangeeta Mehta, M.D.,
  • Hector Quiroz-Martinez, M.D.,
  • Oleksa G. Rewa, M.D.,
  • Emmanuel Charbonney, M.D., Ph.D.,
  • Andrew J.E. Seely, M.D., Ph.D.,
  • Demetrios J. Kutsogiannis, M.D., M.H.S.,
  • Remi LeBlanc, M.D.,
  • Armand Mekontso-Dessap, M.D., Ph.D.,
  • Tina S. Mele, M.D., Ph.D.,
  • Alexis F. Turgeon, M.D.,
  • Gordon Wood, M.D.,
  • Sandeep S. Kohli, M.D.,
  • Jason Shahin, M.D.C.M.,
  • Pawel Twardowski, M.D., Ph.D.,
  • and Neill K.J. Adhikari, M.D.C.M.

for the LOVIT Investigators and the Canadian Critical Care Trials Group*

Abstract

Background

Studies that have evaluated the use of intravenous vitamin C in adults with sepsis who were receiving vasopressor therapy in the intensive care unit (ICU) have shown mixed results with respect to the risk of death and organ dysfunction.

Methods

In this randomized, placebo-controlled trial, we assigned adults who had been in the ICU for no longer than 24 hours, who had proven or suspected infection as the main diagnosis, and who were receiving a vasopressor to receive an infusion of either vitamin C (at a dose of 50 mg per kilogram of body weight) or matched placebo administered every 6 hours for up to 96 hours. The primary outcome was a composite of death or persistent organ dysfunction (defined by the use of vasopressors, invasive mechanical ventilation, or new renal-replacement therapy) on day 28.
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Conclusions

In adults with sepsis receiving vasopressor therapy in the ICU, those who received intravenous vitamin C had a higher risk of death or persistent organ dysfunction at 28 days than those who received placebo. (Funded by the Lotte and John Hecht Memorial Foundation; LOVIT ClinicalTrials.gov number, NCT03680274. opens in new tab.)

https://www.nejm.org/doi/full/10.1056/NEJMoa2200644

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