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维生素 C 可缩短 ICU 住院时间:一项荟萃分析。

Vitamin C Can Shorten the Length of Stay in the ICU: A Meta-Analysis.

机构信息

Department of Public Health, University of Helsinki, POB 41, FI-00014 Helsinki, Finland.

School of Public Health, University of Sydney, Sydney 2006, Australia.

出版信息

Nutrients. 2019 Mar 27;11(4):708. doi: 10.3390/nu11040708.

Abstract

A number of controlled trials have previously found that in some contexts, vitamin C can have beneficial effects on blood pressure, infections, bronchoconstriction, atrial fibrillation, and acute kidney injury. However, the practical significance of these effects is not clear. The purpose of this meta-analysis was to evaluate whether vitamin C has an effect on the practical outcomes: length of stay in the intensive care unit (ICU) and duration of mechanical ventilation. We identified 18 relevant controlled trials with a total of 2004 patients, 13 of which investigated patients undergoing elective cardiac surgery. We carried out the meta-analysis using the inverse variance, fixed effect options, using the ratio of means scale. In 12 trials with 1766 patients, vitamin C reduced the length of ICU stay on average by 7.8% (95% CI: 4.2% to 11.2%; = 0.00003). In six trials, orally administered vitamin C in doses of 1⁻3 g/day (weighted mean 2.0 g/day) reduced the length of ICU stay by 8.6% ( = 0.003). In three trials in which patients needed mechanical ventilation for over 24 hours, vitamin C shortened the duration of mechanical ventilation by 18.2% (95% CI 7.7% to 27%; = 0.001). Given the insignificant cost of vitamin C, even an 8% reduction in ICU stay is worth exploring. The effects of vitamin C on ICU patients should be investigated in more detail.

摘要

先前有一些对照试验发现,在某些情况下,维生素 C 对血压、感染、支气管收缩、心房颤动和急性肾损伤可能具有有益影响。然而,这些影响的实际意义尚不清楚。本荟萃分析的目的是评估维生素 C 是否对以下实际结果有影响:重症监护病房(ICU)的住院时间和机械通气时间。我们确定了 18 项相关的对照试验,共涉及 2004 名患者,其中 13 项研究了接受择期心脏手术的患者。我们使用逆方差、固定效应选项、均数比尺度进行荟萃分析。在 12 项涉及 1766 名患者的试验中,维生素 C 平均使 ICU 住院时间缩短了 7.8%(95%CI:4.2%至 11.2%; = 0.00003)。在 6 项每天给予 1⁻3 克维生素 C(平均剂量为 2.0 克/天)的试验中,维生素 C 使 ICU 住院时间缩短了 8.6%( = 0.003)。在需要机械通气超过 24 小时的 3 项试验中,维生素 C 使机械通气时间缩短了 18.2%(95%CI:7.7%至 27%; = 0.001)。鉴于维生素 C 的成本微不足道,即使 ICU 住院时间缩短 8%也值得探讨。应更详细地研究维生素 C 对 ICU 患者的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9a63/6521194/51e3f2fe7198/nutrients-11-00708-g001.jpg

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