Programa de Doctorado en Farmacología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico.
Unidad de Cuidados Intensivos, Hospital General Regional 110, Instituto Mexicano del Seguro Social, Guadalajara 44716, Mexico.
Medicina (Kaunas). 2024 Mar 12;60(3):464. doi: 10.3390/medicina60030464.
: According to the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3), sepsis is defined as "life-threatening organ dysfunction caused by a dysregulated host response to infection". The increased presence of free radicals causes an increase in oxidative stress. Vitamin C is an essential water-soluble vitamin with antioxidant activity and immunoregulatory effects that plays a potential role in the treatment of bacterial infections. Our aim was to evaluate the effectiveness of adding vitamin C to the conventional treatment of sepsis to decrease its mortality rate. In a prospective cohort study, we included patients with a diagnosis of sepsis and a SOFA score ≥ 9 who were evaluated in an Intensive Care Unit at a secondary-care hospital. According to the intensive care specialist, they were treated using two different strategies: Group 1-patients with sepsis treated with conventional treatment without vitamin C; Group 2-patients with sepsis with the addition of vitamin C to conventional treatment. We included 34 patients with sepsis. The incidence of mortality was 38%, and 47% of patients used vitamin C as an adjuvant to the basic treatment of sepsis. In the basal analyses, patients treated with use of vitamin C compared to patients treated without vitamin C required less use of glucocorticoids (75% vs. 100%, = 0.039). At follow-up, patients treated without vitamin C had higher mortality than patients treated with vitamin C as an adjuvant for the treatment of sepsis (55.6% vs. 18.8%, = 0.03). We observed that the use of vitamin C was a protective factor for mortality in patients with sepsis (RR: 0.54, 95% CI: 0.31-0.96, = 0.03). The use of vitamin C as an adjuvant to treatment decreases the risk of mortality by 46% in patients with sepsis and SOFA ≥ 9 compared to patients treated without vitamin C as an adjuvant to sepsis.
根据第三届国际脓毒症和脓毒性休克定义共识(Sepsis-3),脓毒症定义为“宿主对感染的失调反应引起的危及生命的器官功能障碍”。自由基的增加会导致氧化应激增加。维生素 C 是一种必需的水溶性维生素,具有抗氧化和免疫调节作用,在治疗细菌感染方面具有潜在作用。我们的目的是评估在常规治疗中添加维生素 C 治疗脓毒症以降低其死亡率的效果。
在一项前瞻性队列研究中,我们纳入了在二级保健医院的重症监护病房中诊断为脓毒症且 SOFA 评分≥9 的患者。根据重症监护专家的意见,他们接受了两种不同的治疗策略:第 1 组-接受常规治疗而未使用维生素 C 的脓毒症患者;第 2 组-接受常规治疗加维生素 C 的脓毒症患者。
我们纳入了 34 例脓毒症患者。死亡率为 38%,47%的患者使用维生素 C 作为脓毒症基本治疗的辅助药物。在基础分析中,与未使用维生素 C 治疗的患者相比,使用维生素 C 治疗的患者需要使用糖皮质激素的比例较低(75% vs. 100%, = 0.039)。在随访时,未使用维生素 C 治疗的患者死亡率高于使用维生素 C 作为脓毒症辅助治疗的患者(55.6% vs. 18.8%, = 0.03)。我们观察到,在脓毒症患者中,使用维生素 C 是降低死亡率的保护因素(RR:0.54,95%CI:0.31-0.96, = 0.03)。与未使用维生素 C 作为脓毒症辅助治疗的患者相比,在 SOFA≥9 的脓毒症患者中,使用维生素 C 作为治疗辅助可使死亡率降低 46%。