• Curr Opin Crit Care · Dec 2019

    Review

    Vitamin C in surgical sepsis.

    • Tanya Anand, Lauren K Roller, and Gregory J Jurkovich.
    • University of Arizona, Division of Trauma, Burns, Acute Care Surgery, Tucson, Arizona.
    • Curr Opin Crit Care. 2019 Dec 1; 25 (6): 712-716.

    Purpose Of ReviewThe current review discusses the supplemental use of vitamin C as an adjunct in the management of sepsis and septic shock.Recent FindingsThe antioxidant properties of vitamin C are touted to be useful in modulating the inflammatory response, decreasing vasopressor requirements, and improving resuscitation. Current resuscitation practices are focused on addressing the hemodynamic instability and ensuring adequate oxygen delivery to tissues. The conceptual framework of the use of vitamin C during a resuscitation is to modulate in a beneficial fashion the inflammatory response to sepsis while concomitantly resuscitating and treating the infection. While there is promising animal and burn-related data on improved fluid resuscitation with the use of vitamin C as an adjunct, the most recent meta-analyses of the available data fail to show a survival benefit in sepsis, and concerns regarding nephrotoxicity remain.SummaryAlthough there are large number of animal studies, only a few small prospective and retrospective studies in humans address the use of vitamin C to treat sepsis. Further research in a controlled and randomized fashion is needed to determine if vitamin C is effective in this role. While there is a promise of ascorbate's addition to the sepsis bundle as an adjunct to resuscitation, the evidence is not conclusive.

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