Emergency Medicine Department, George Washington University School of Medicine and Health Sciences, Washington, DC, United States.
Emergency Medicine Department, George Washington University School of Medicine and Health Sciences, Washington, DC, United States.
J Crit Care. 2018 Feb;43:230-234. doi: 10.1016/j.jcrc.2017.09.031. Epub 2017 Sep 18.
Sepsis is a life-threatening medical condition, affecting approximately 26 million people worldwide every year. The disease is a continuum, marked by dysregulated inflammation and hemodynamic instability leading to shock, multi-system organ dysfunction, and death. Over the past decades, there has been a focus on the early identification and treatment of sepsis primarily with bundled and goal directed therapy. Despite these advances, morbidity and mortality has remained high, prompting investigation into novel therapies. Vitamin C is a water-soluble vitamin that plays a role in mediating inflammation through antioxidant activities and is also important in the synthesis of cortisol, catecholamines, and vasopressin, which are key mediators in the disease process. Emerging evidence provides cursory data in support of the administration of vitamin C in addition to standard therapy to ameliorate the effects of inflammation and improve hemodynamic stability in patients with sepsis and septic shock; however, further evidence is needed to support this practice. This review discusses the physiologic role of vitamin C as well as the recent literature and evidence for the use of vitamin C in patients presenting with sepsis.
脓毒症是一种危及生命的医疗状况，全球每年约有 2600 万人受到影响。该病是一个连续的过程，以失调的炎症和血液动力学不稳定为特征，导致休克、多器官功能障碍和死亡。在过去几十年中，人们主要关注脓毒症的早期识别和治疗，采用集束化和目标导向治疗。尽管取得了这些进展，但发病率和死亡率仍然居高不下，促使人们研究新的治疗方法。维生素 C 是一种水溶性维生素，通过抗氧化活性在介导炎症中发挥作用，对皮质醇、儿茶酚胺和血管加压素的合成也很重要，这些都是疾病过程中的关键介质。新出现的证据提供了初步数据支持在标准治疗之外给予维生素 C，以减轻炎症的影响并改善脓毒症和脓毒性休克患者的血液动力学稳定性；然而，还需要更多的证据来支持这种做法。本文讨论了维生素 C 的生理作用，以及最近关于维生素 C 在脓毒症患者中的应用的文献和证据。
