https://www.medpagetoday.com/criticalcare/sepsis/99248
Headline is that vitamin C now harms sepsis patients! (Notice that you can't easily read this paper)
Moderators: ofonorow, popnowlin
Overall, the trial demonstrated that for patients with sepsis admitted to the ICU who were on vasopressor therapy, intravenous vitamin C was associated with a higher risk of death or persistent organ dysfunction.
Neurological dysfunction is frequent during sepsis. Both sepsis and high dose vasopressor therapy may negatively impact cerebral perfusion and/or oxygenation. The best way to monitor and to manage patients suffering from sepsis-induced neurological dysfunction remains to be elucidated.
Results
A total of 872 patients underwent randomization (435 to the vitamin C group and 437 to the control group). The primary outcome occurred in 191 of 429 patients (44.5%) in the vitamin C group and in 167 of 434 patients (38.5%) in the control group (risk ratio, 1.21; 95% confidence interval [CI], 1.04 to 1.40; P=0.01). At 28 days, death had occurred in 152 of 429 patients (35.4%) in the vitamin C group and in 137 of 434 patients (31.6%) in the placebo group (risk ratio, 1.17; 95% CI, 0.98 to 1.40) and persistent organ dysfunction in 39 of 429 patients (9.1%) and 30 of 434 patients (6.9%), respectively (risk ratio, 1.30; 95% CI, 0.83 to 2.05). Findings were similar in the two groups regarding organ-dysfunction scores, biomarkers, 6-month survival, health-related quality of life, stage 3 acute kidney injury, and hypoglycemic episodes. In the vitamin C group, one patient had a severe hypoglycemic episode and another had a serious anaphylaxis event.
François Lamontagne 1 , Marie-Hélène Masse 1 , Julie Menard 1 , Sheila Sprague 1 , Ruxandra Pinto 1 , Daren K Heyland 1 , Deborah J Cook 1 , Marie-Claude Battista 1 , Andrew G Day 1 , Gordon H Guyatt 1 , Salmaan Kanji 1 , Rachael Parke 1 , Shay P McGuinness 1 , Bharath-Kumar Tirupakuzhi Vijayaraghavan 1 , Djillali Annane 1 , Dian Cohen 1 , Yaseen M Arabi 1 , Brigitte Bolduc 1 , Nicole Marinoff 1 , Bram Rochwerg 1 , Tina Millen 1 , Maureen O Meade 1 , Lori Hand 1 , Irene Watpool 1 , Rebecca Porteous 1 , Paul J Young 1 , Frederick D'Aragon 1 , Emilie P Belley-Cote 1 , Elaine Carbonneau 1 , France Clarke 1 , David M Maslove 1 , Miranda Hunt 1 , Michaël Chassé 1 , Martine Lebrasseur 1 , François Lauzier 1 , Sangeeta Mehta 1 , Hector Quiroz-Martinez 1 , Oleksa G Rewa 1 , Emmanuel Charbonney 1 , Andrew J E Seely 1 , Demetrios J Kutsogiannis 1 , Remi LeBlanc 1 , Armand Mekontso-Dessap 1 , Tina S Mele 1 , Alexis F Turgeon 1 , Gordon Wood 1 , Sandeep S Kohli 1 , Jason Shahin 1 , Pawel Twardowski 1 , Neill K J Adhikari 1 , LOVIT Investigators and the Canadian Critical Care Trials Group
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.
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