Abstract
Sepsis is a life-threatening illness that is caused by a complex interaction between the infecting organism and the patient's dysregulated response to infection. The consequences of sepsis are generally negative with mortality estimated to be between 20-40%. Currently, there is significant interest in the possible adjunct role of high dose intravenous (IV) vitamin C in managing sepsis in ICU.
The aim of this study was to assess whether intravenously administered vitamin C would reduce organ damage, levels of inflammation and oxidative stress in critically ill septic patients. This study followed 37 septic patients in the ICU department in Christchurch Hospital. There was a placebo group (n =19) and a treatment group (n=18) that received 100 mg/kg/day of vitamin C at 6 hourly intervals for four days. Sequential Organ Function Assessment (SOFA) scores were evaluated each day by nursing staff for four days for both groups to determine the severity of organ dysfunction. C-reactive protein (CRP) concentrations were measured by Canterbury Health Laboratories in both groups each day as a measure of systemic inflammation. Protein carbonyl concentrations were measured in both groups by enzyme-linked immunosorbent assay (ELISA) as a measure of systemic oxidation. SOFA scores, plasma CRP and carbonyl concentrations for the total cohort were significantly different from baseline. For the cohort, SOFA scores and CRP levels decreased, whereas protein carbonyls increased. However, the SOFA scores didn't show a significant difference between placebo and treatment groups, nor did the CRP or protein carbonyls.
The study sample was relatively small with the treatment and control groups losing patients through discharges and deaths before all data was collected.The research was an interim analysis of a pilot study; further measurement of other biomarkers and clinical outcomes collected as part of this study may reveal significant effects of the vitamin C intervention. Other larger trials are also currently underway around the world.