Thakare Pallav V, Gaurkar Sagar S, Mohale Sandip A, Bharadia Gopikishan, Acharya Sourya
Internal Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Otolaryngology - Head and Neck Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Cureus. 2024 Aug 19;16(8):e67184. doi: 10.7759/cureus.67184. eCollection 2024 Aug.
Vitamin C, a key nutrient with potent antioxidant and immunomodulatory properties, has been explored for its therapeutic potential in treating severe infections, particularly sepsis. This systematic review aims to evaluate the effectiveness of parenteral vitamin C in improving clinical outcomes in patients with severe infections. A comprehensive search of several databases, including PubMed, EMBASE, and the Cochrane Library, was conducted for studies published between January 2000 and June 2024. Included were randomized controlled trials, observational studies, and case reports that examined the use of parenteral vitamin C in adult patients with severe infections. Data extracted included study design, sample size, intervention specifics, and clinical outcomes. Quality was assessed using tools appropriate to each study design, such as the Cochrane Risk of Bias Tool and the Newcastle-Ottawa Scale. The review included nine studies with diverse methodologies. While individual studies reported benefits such as improved immune function and reduced oxidative stress, larger systematic reviews and meta-analyses did not demonstrate a significant reduction in mortality. The results indicate that while parenteral vitamin C may improve certain biochemical and physiological parameters, these improvements do not consistently translate into enhanced survival or substantial clinical benefits. Parenteral vitamin C shows potential in modulating immune response and reducing oxidative damage in severe infections. However, its impact on key clinical outcomes like mortality and long-term recovery remains uncertain. This review highlights the need for further high-quality, randomized controlled trials to clarify vitamin C's role in managing severe infections and define optimal therapeutic protocols.
维生素C是一种具有强大抗氧化和免疫调节特性的关键营养素，其在治疗严重感染尤其是脓毒症方面的治疗潜力已得到探索。本系统评价旨在评估肠外维生素C对改善严重感染患者临床结局的有效性。对包括PubMed、EMBASE和Cochrane图书馆在内的多个数据库进行了全面检索，以查找2000年1月至2024年6月发表的研究。纳入的研究包括随机对照试验、观察性研究和病例报告，这些研究考察了肠外维生素C在成年严重感染患者中的使用情况。提取的数据包括研究设计、样本量、干预细节和临床结局。使用适合每种研究设计的工具评估质量，如Cochrane偏倚风险工具和纽卡斯尔-渥太华量表。该评价纳入了9项方法各异的研究。虽然个别研究报告了诸如免疫功能改善和氧化应激降低等益处，但更大规模的系统评价和荟萃分析并未显示死亡率有显著降低。结果表明，虽然肠外维生素C可能改善某些生化和生理参数，但这些改善并未始终转化为生存率提高或显著的临床益处。肠外维生素C在调节严重感染中的免疫反应和减少氧化损伤方面显示出潜力。然而，其对死亡率和长期恢复等关键临床结局的影响仍不确定。本评价强调需要进一步开展高质量的随机对照试验，以阐明维生素C在管理严重感染中的作用并确定最佳治疗方案。
