New evidence calls into question vitamin C as a treatment for sepsis

Study findings differ from prior research that linked vitamin C to reduced mortality rates among patients with septic shock.

When Dr. Vinay Dhingra first read a study, which seemed to prove the benefits of vitamin C for treating septic shock, he was skeptical. 

“The study was quite small, and the benefit quite high considering,” recalls the Vancouver Coastal Health Research Institute clinician-scientist who has worked in the Intensive Care Unit (ICU) at Vancouver General Hospital since 1998.

A leading cause of death internationally, and the 12th leading cause of death in Canada1, sepsis occurs when the body’s response to infection damages multiple organ systems. The treatment course for the condition involves mainly antibiotics, infection source control, intravenous fluid, vasopressors—blood pressure boosters—and organ support, along with adjuvants—immune response enhancers—such as corticosteroids. Vitamin C was not formerly included in the mix.     

Dr. Vinay Dhingra is a clinician-scientist and a clinical professor in the Department of Medicine at the University of British Columbia.

The 2017 vitamin C study examined 94 patients with sepsis, and found that only 8.5 per cent of patients who received intravenous vitamin C combined with corticosteroids died from their condition, compared with 40.4 percent of patients who did not receive intravenous vitamin C.

Despite some concern about the study’s design and the small number of participants, its influence spread throughout the medical community, and became a reason why many hospitals introduced intravenous vitamin C into their treatment course for septic patients.

“The study was taken up very heavily by social media and the mainstream media, and there were even groups who suggested that physicians who did not administer vitamin C were not delivering adequate therapy,” says Dhingra.

“Our research looked at what data we had that could support or refute these findings.”

Results reverse the trend, demonstrating no significant benefit of vitamin C for sepsis

Dhingra’s research, published in the Canadian Journal of Anesthesia, adds to a growing body of evidence that calls into question the prior findings about vitamin C’s effectiveness as a treatment for sepsis. 

Dhingra’s historical cohort study of 140 septic patients, 52 of whom received vitamin C and corticosteroids and 88 who received corticosteroids alone, found no variation in mortality rates between the two groups. 

Neither did they find any statistically significant difference in ICU mortality rates, the time patients spent in the ICU nor the number of days patients required a ventilator, vasopressor or dialysis.

The group of patients who received vitamin C and corticosteroids received a minimum of 1,500 milligrams of vitamin C every six hours for at least 96 hours. 

While vitamin C is considered to be fairly benign in a clinical setting, one of the roles of the health research community is to ensure that treatments are based on sound science, not conjecture, says Dhingra. 

“At the end of the day, as a physician, quality of care is paramount,” he says. “Finding the truth on how best to treat each patient is vital to the practice of medicine. This includes validating treatment recommendations.” 

“We want to be able to scientifically show that we are providing the best care possible.” 

1 Canadian Sepsis Foundation 

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