Could Vitamin C Infusions Save Patients With Sepsis?

Could Vitamin C Infusions Save Patients With Sepsis?

Massive vitamin C infusions could be a life-saver for patients with sepsis, an inflammatory condition run amok, new research suggests.
Sepsis is a leading cause of death in U.S. hospitals, claiming as many as 300,000 lives a year, according to the U.S. National Institute of General Medical Sciences.

"It's literally an explosion of the body's immune defense," said the study's lead author, Dr. Alpha Fowler III, a professor of medicine at Virginia Commonwealth University, in Richmond. "Sepsis is the body's response to a severe invading infection of bacteria or viruses or fungi." Blood pressure plunges and widespread organ failure follows.

Fowler's team found that four days of infusions with vitamin C reduced a patient's risk of death within a month of treatment from 46% to 30%.

For the study, the investigators tracked 167 patients treated for sepsis at one of seven intensive care units between 2014 and 2017. All had been placed on a mechanical ventilator due to acute respiratory distress syndrome.

Half were randomly assigned to receive vitamin C infusions every six hours for four days. The others received standard care, which typically involves large amounts of intravenous fluids and drugs, including antibiotics.

After four days, the team saw no difference in risk of organ failure. Nineteen standard-care patients died during that time period, compared to four treated with vitamin C. And while nine vitamin C patients left the ICU during treatment, only one of the others had, the researchers said.

Over several weeks, patients who received vitamin C had spent significantly less time in the hospital. A 30-day follow-up found vitamin C patients averaged nearly 11 ICU-free days versus about 8 ICU-free days for those receiving standard care. Over 60 days, the vitamin C patients also had spent about a week less in the hospital overall than the standard-care group.

"Most importantly, we showed that we could improve survival," Fowler said.

But what explains vitamin C's power?

Fowler said it's important to distinguish between widely used supplements and the treatment under review.

"When you take vitamin C orally you cannot develop any kind of a meaningful blood level of vitamin C - not even in massive doses," he said. Given intravenously, "we can reach blood levels that are 3,000 times higher. And at that point it's no longer just a vitamin. It becomes a very potent anti-inflammatory agent. And that is what's saving lives."

Ultimately, he said, it could be "a total game-changer."

The findings were published in the Oct. 1 issue of the Journal of the American Medical Association.
That level of enthusiasm is not shared by Dr. Emily Brant, co-author of an editorial that accompanied the study. She's an attending physician at the University of Pittsburgh School of Medicine.

"Though they did demonstrate a mortality benefit among patients who received vitamin C, these results must be interpreted with caution," she said. "They did not see any difference in markers of organ injury or inflammation between groups, something we'd expect to see if the mortality benefit is real."

She said the results are interesting and should be tested in further studies. But, she added, they are "not dramatic, nor game-changing. More work is necessary before vitamin C infusions are considered the standard of care."

Fowler and his team said that they hope to launch a new trial with 300 patients across 65 hospitals by next year.

Sources: Alpha A. Fowler III, M.D., professor of medicine, VCU Johnson Center for Critical Care and Pulmonary Research, Virginia Commonwealth University School of Medicine, Richmond, Va.; Emily Brant, M.D., attending physician, department of critical care medicine, University of Pittsburgh School of Medicine; Oct. 1, 2019, Journal of the American Medical Association

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