Müller Mattia M, Pinto Ruxandra, Lamontagne François, Adhikari Neill K J, Del Sorbo Lorenzo
Institute of Intensive Care Medicine, University Hospital Zurich, Zurich, ZH, Switzerland.
Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Crit Care Explor. 2025 Sep 5;7(9):e1310. doi: 10.1097/CCE.0000000000001310. eCollection 2025 Sep.
Vitamin C has been linked to alterations in platelet count and aggregation behavior. Given recent findings suggesting an association between vitamin C and adverse outcomes in patients with septic shock, we aimed to investigate whether vitamin C influences mortality in septic patients through its impact on platelets.
Post hoc analysis of the Lessening Organ Dysfunction With Vitamin C (LOVIT) randomized trial (clinicaltrials.gov NCT03680274).
Multicenter international study.
Patients were included with an ICU stay of more than 24 hours, confirmed or suspected infection, vasopressor requirement, and availability of platelet count data.
Vitamin C (50 mg/kg body weight) every 6 hours for 4 days, or placebo.
Of the 863 patients enrolled in the LOVIT trial, 859 had available platelet count data at any time. Although the longitudinal trajectory of platelet count was significantly associated with 28-day mortality (hazard ratio 0.97 per 10 × 10/L increase, 95% CI, 0.96-0.98), there was no interaction between the effect of vitamin C on mortality and either platelet count at baseline or over time.
These results do not support the hypothesis that vitamin C administration increases mortality risk by affecting platelet count.
维生素C与血小板计数及聚集行为的改变有关。鉴于最近的研究结果表明维生素C与感染性休克患者的不良结局之间存在关联，我们旨在研究维生素C是否通过对血小板的影响来影响脓毒症患者的死亡率。
对维生素C减轻器官功能障碍（LOVIT）随机试验（clinicaltrials.gov NCT03680274）进行事后分析。
多中心国际研究。
纳入入住重症监护病房超过24小时、确诊或疑似感染、需要血管活性药物支持且有血小板计数数据的患者。
每6小时给予维生素C（50mg/kg体重），共4天，或给予安慰剂。
在LOVIT试验纳入的863例患者中，859例在任何时间均有可用的血小板计数数据。尽管血小板计数的纵向轨迹与28天死亡率显著相关（每增加10×10⁹/L，风险比为0.97，95%置信区间为0.96-0.98），但维生素C对死亡率的影响与基线或随访期间的血小板计数之间均无相互作用。
这些结果不支持维生素C通过影响血小板计数增加死亡风险这一假说。
