Effect of vitamin C on patients with sepsis and septic shock: a meta-analysis

doi:10.3877/cma.j.issn.1674-6880.2019.01.007

Abstract

Abstract:

Objective

To systemically explore the efficacy of vitamin C intravenous infusion on patients with sepsis and septic shock.

Methods

A systematic search for randomized controlled trials on comparing the vitamin C treatment group and control group of patients with sepsis and septic shock was performed from PubMed, EMBASE, The Cochrane Library, Web of Science, Wanfang data, CBM, CNKI from their inception to August 2018. Two reviewers independently screened studies, extracted data and assessed methodological quality according to the inclusion criteria. Then meta-analysis was conducted using RevMan 5.3 software.

Results

A total of 6 studies with 318 patients were included. The random effect model in meta-analysis showed that there was no significant difference in total mortality between vitamin C treatment and control groups [RR= 0.82, 95%CI (0.48, 1.38), Z= 0.76, P= 0.45]. The funnel plot demonstrated publication bias between those studies.

Conclusion

Intravenous infusion of vitamin C does not reduce the mortality of patients with sepsis and septic shock.

Key words: Vitamins, Sepsis, Shock, septic, Meta-analysis

Xueni Chang, Min Li, Zhengxin Zhang, Yu Chen, Chenming Dong. Effect of vitamin C on patients with sepsis and septic shock: a meta-analysis[J]. Chinese Journal of Critical Care Medicine(Electronic Edition), 2019, 12(01): 37-41.

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Figures/Tables 3

References 28

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作者	试验组		对照组		随访时间（d）
作者	例数	治疗方案	例数	干预措施	随访时间（d）
Pontes-Arruda等^[15]	55	6 h内给予富含二十碳五烯酸、亚麻酸和抗氧化维生素的肠内营养剂，达到基础代谢率的50%以上	48	6 h内给予高脂肪，低碳水化合物肠内营养剂，达到基础代谢率的50%以上	28
Fowler等^[18]	8	维生素C 50 mg/kg + 5%葡萄糖50 mL，输注时间大于30 min，每6小时1次，连用4 d	8	5%葡萄糖	28
Galley等^[20]	16	N-乙酰半胱氨酸150 mg/kg，静脉推注30 min，然后20 mg·kg-1·h^-1 +维生素C 1 g +维生素E 400 mg，静脉滴注	14	5%葡萄糖	28
Ferrón-Celma等^[17]	10	术后12 h开始输注维生素C 150 mg/kg+5%葡萄糖50 mL，每8小时1次，连用6 d	10	5%葡萄糖	ICU住院时间
Marik等^[19]	47	维生素C 1.5 g + 5%葡萄糖100 mL，静脉滴注，每6小时1次，输注时间30~60 min，连用4 d或至出ICU	47	标准治疗	住院时间
Beale等^[16]	27	第1天胃管内注入肠内营养剂（Intestamin^?）500 mL，第2 ~ 10天给予肠内营养剂（Intestamin^?500 mL+Reconvan^? 1 000 mL），第11天至出ICU，给予肠内营剂（Reconvan^?）	28	第1天胃管内注入对照剂500 mL，第2 ~ 10天给予对照剂500 mL +肠内营养剂1 000 mL，第11天至出ICU，给予肠内营养剂	ICU住院时间

作者	试验组		对照组		随访时间（d）
作者	例数	治疗方案	例数	干预措施	随访时间（d）
Pontes-Arruda等^[15]	55	6 h内给予富含二十碳五烯酸、亚麻酸和抗氧化维生素的肠内营养剂，达到基础代谢率的50%以上	48	6 h内给予高脂肪，低碳水化合物肠内营养剂，达到基础代谢率的50%以上	28
Fowler等^[18]	8	维生素C 50 mg/kg + 5%葡萄糖50 mL，输注时间大于30 min，每6小时1次，连用4 d	8	5%葡萄糖	28
Galley等^[20]	16	N-乙酰半胱氨酸150 mg/kg，静脉推注30 min，然后20 mg·kg-1·h^-1 +维生素C 1 g +维生素E 400 mg，静脉滴注	14	5%葡萄糖	28
Ferrón-Celma等^[17]	10	术后12 h开始输注维生素C 150 mg/kg+5%葡萄糖50 mL，每8小时1次，连用6 d	10	5%葡萄糖	ICU住院时间
Marik等^[19]	47	维生素C 1.5 g + 5%葡萄糖100 mL，静脉滴注，每6小时1次，输注时间30~60 min，连用4 d或至出ICU	47	标准治疗	住院时间
Beale等^[16]	27	第1天胃管内注入肠内营养剂（Intestamin^?）500 mL，第2 ~ 10天给予肠内营养剂（Intestamin^?500 mL+Reconvan^? 1 000 mL），第11天至出ICU，给予肠内营剂（Reconvan^?）	28	第1天胃管内注入对照剂500 mL，第2 ~ 10天给予对照剂500 mL +肠内营养剂1 000 mL，第11天至出ICU，给予肠内营养剂	ICU住院时间

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