Vitamin C alone does not improve treatment outcomes in mechanically ventilated patients with severe sepsis or septic shock: a retrospective cohort study
Vitamin C alone does not improve treatment outcomes in mechanically ventilated patients with severe sepsis or septic shock: a retrospective cohort study
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DOI：
10.21037/jtd.2019.03.03
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发表时间：
2019-04-01
影响因子：
2.5
通讯作者：
Hong, Sang-Bum
中科院分区：
文献类型：
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作者：
Ahn, Jee Hwan;Oh, Dong Kyu;Hong, Sang-Bum
背景：在临床前研究中，维生素C对脓毒症有几种有益作用。然而，支持这些报告的临床数据很少。本研究旨在评估连续静脉维生素C治疗是否可以降低严重脓毒症或脓毒性休克需要机械通气的患者的住院死亡率。方法：对于这项回顾性队列研究，包括连续的重症监护病房严重脓毒症或脓毒性休克需要机械通气的患者。根据静脉注射维生素C（每8小时2 g）的情况，将研究患者分为维生素C组或对照组。结果：维生素C组35例，对照组40例。两组在ICU入院时的基线特征方面具有可比性。维生素C组的住院死亡率为46%（35例患者中的16例），对照组为40%（40例患者中的16例），显示统计学无显著差异（P=0.62）。ICU入院后90天的死亡率（60% vs. 48%）在两组之间没有显著差异。两组中至电击逆转的中位时间均为3天[四分位距（IQR），2 - 5天]。在ICU的前4天内，维生素C组和对照组的脓毒症相关器官衰竭评估（SOFA）评分的变化分别为-1.4 +/- 3.3和-1.4 +/- 3.0。结论：单独静脉补充维生素C治疗不能降低严重脓毒症或脓毒性休克机械通气患者的住院死亡率。
Background: Vitamin C has shown several beneficial effects on sepsis in preclinical studies. However, clinical data supporting these reports are scarce. This study aimed to evaluate whether adjunctive intravenous vitamin C therapy could reduce hospital mortality in patients with severe sepsis or septic shock requiring mechanical ventilation.Methods: For this retrospective cohort study, consecutive medical ICU patients with severe sepsis or septic shock requiring mechanical ventilation were included. The study patients were classified into the vitamin C or control groups depending on the administration of intravenous vitamin C (2 g every 8 hours). The primary outcome was hospital mortality.Results: Thirty-five patients in the vitamin C group and 40 patients in the control group were included. The two groups were comparable in regards to the baseline characteristics at ICU admission. The hospital mortality was 46% (16 of 35 patients) in the vitamin C group and 40% (16 of 40 patients) in the control group, showing a statistically nonsignificant difference (P=0.62). The mortality at 90 days after ICU admission (60% vs. 48%) did not significantly differ between groups. The median time to shock reversal was 3 days [interquartile range (IQR), 2 to 5 days] in both groups. The changes in the Sepsis-related Organ Failure Assessment (SOFA) scores during the first 4 ICU days were -1.4 +/- 3.3 and -1.4 +/- 3.0 in the vitamin C and control groups, respectively.Conclusions: Adjunctive intravenous vitamin C therapy alone did not reduce hospital mortality in mechanically ventilated patients with severe sepsis or septic shock.