The Benefits of High-Dose Vitamin C in Patients with Sepsis

An Evidence-Based Case Report

Authors

  • Mawin Mahen
  • Nabila Hasan
  • Suzy Maria

DOI:

https://doi.org/10.23886/ejki.10.83.151-61

Abstract

In sepsis, there is an increase in oxidative stress which plays important role in further physiological derangement. Due to its potent antioxidant effect, vitamin C has been proposed as a potential adjunct treatment in patients with sepsis. This study aims to evaluate the benefits of vitamin C administration in patients with sepsis. A systematic search was conducted using electronic databases PubMed, Scopus, ProQuest, and Cochrane with keywords combination of vitamin C/ascorbic acid and sepsis/septic. The limits of the search included English language, human subjects, and adults. To limit the confounding effect, only studies with vitamin C monotherapy were considered for inclusion. Seven relevant studies comprising five clinical trials and two retrospective studies were included in this paper for critical appraisal. Most studies found some clinical benefits with the use of vitamin C in patients with sepsis compared to placebo, such as a reduction in SOFA score and mortality. However, these favourable outcomes were not consistent in all studies. In conclusion, vitamin C is a promising adjunct treatment option in patients with sepsis, however further large, optimized multicenter trials are needed to definitively confirm its benefits.

Keywords: vitamin C, ascorbic acid, sepsis, septic shock.

 

Manfaat Vitamin C Dosis Tinggi untuk Pasien Sepsis

Abstrak

Kondisi sepsis menyebabkan peningkatan stres oksidatif yang berperan penting dalam menyebabkan gangguan fisiologis lebih lanjut. Karena memiliki efek antioksidan yang kuat, vitamin C telah diusulkan sebagai terapi adjuvan yang menjanjikan pada pasien sepsis. Penelitian ini bertujuan untuk mengevaluasi manfaat pemberian vitamin C pada pasien sepsis. Pencarian sistematis dilakukan menggunakan database elektronik PubMed, Scopus, ProQuest, dan Cochrane dengan kombinasi kata kunci vitamin C/asam askorbat dan sepsis/ septik. Batas pencarian yaitu bahasa Inggris, subjek manusia, dan usia dewasa. Untuk membatasi efek perancu, hanya studi yang menggunakan monoterapi vitamin C yang dipertimbangkan untuk dimasukkan. Tujuh studi relevan yang terdiri dari lima uji klinis dan dua studi retrospektif dimasukkan dalam tulisan ini untuk telaah kritis. Sebagian besar studi mendapatkan manfaat klinis penggunaan vitamin C pada pasien sepsis dibandingkan dengan plasebo, misalnya penurunan skor SOFA dan angka mortalitas, namun hasil positif ini tidak konsisten dalam semua penelitian. Sebagai kesimpulan, vitamin C adalah pilihan terapi adjuvan yang menjanjikan pada pasien sepsis, namun butuh penelitian multisenter yang lebih besar dan optimal untuk memastikan manfaatnya secara definitif.

Kata kunci: vitamin C, asam askorbat, sepsis, syok sepsis

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Author Biographies

Mawin Mahen

Department of Internal Medicine, Faculty of Medicine Universitas Indonesia

Nabila Hasan

Department of Internal Medicine, Faculty of Medicine Universitas Indonesia

Suzy Maria

Division of Allergy and Immunology, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia

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Published

2022-09-05

How to Cite

Mahen, M., Hasan, N., & Maria, S. (2022). The Benefits of High-Dose Vitamin C in Patients with Sepsis: An Evidence-Based Case Report. EJournal Kedokteran Indonesia, 10(2), 151–61. https://doi.org/10.23886/ejki.10.83.151-61

Issue

Section

Evidence-based Case Report
Received 2021-10-10
Accepted 2022-08-31
Published 2022-09-05