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Article

Intravenous Vitamin C as an Add-on Therapy for the Treatment of Sepsis in an Intensive Care Unit: A Prospective Cohort Study

by
Sergio Antonio Gonzalez-Vazquez
1,2,
Eli Efrain Gomez-Ramirez
3,
Laura Gonzalez-Lopez
3,4,
Jorge Ivan Gamez-Nava
3,4,
Juan Angel Peraza-Zaldivar
1,
Aline Priscilla Santiago-Garcia
1,
Melissa Ramirez-Villafaña
3,
Fabiola Gonzalez-Ponce
3,
Jose Jorge Gomez-Camarena
1,
Ana Miriam Saldaña-Cruz
3,
Norma Alejandra Rodriguez-Jimenez
3,
J. Ahuixotl Gutierrez-Aceves
1,
Adriana Jimenez-Lopez
5,
Sylvia Elena Totsuka-Sutto
3,
Ernesto German Cardona-Muñoz
3 and
Juan Manuel Ponce-Guarneros
3,*
1
Programa de Doctorado en Farmacología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico
2
Unidad de Cuidados Intensivos, Hospital General Regional 110, Instituto Mexicano del Seguro Social, Guadalajara 44716, Mexico
3
Instituto de Terapéutica Experimental y Clínica, Departamento de Fisiología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico
4
Programa de Maestría en Salud Publica, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico
5
Especialistas en Medicina Critica, Hospital Terranova, Guadalajara 44670, Mexico
*
Author to whom correspondence should be addressed.
Medicina 2024, 60(3), 464; https://doi.org/10.3390/medicina60030464
Submission received: 10 January 2024 / Revised: 27 February 2024 / Accepted: 28 February 2024 / Published: 12 March 2024
(This article belongs to the Special Issue New Strategies for the Diagnosis and Treatment of Sepsis and Septic Shock)
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Abstract

Background and Objectives: 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. Materials and Methods: 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. Results: 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%, p = 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%, p = 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, p = 0.03). Conclusions: 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.
Keywords: sepsis; vitamin C; mortality sepsis; vitamin C; mortality

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MDPI and ACS Style

Gonzalez-Vazquez, S.A.; Gomez-Ramirez, E.E.; Gonzalez-Lopez, L.; Gamez-Nava, J.I.; Peraza-Zaldivar, J.A.; Santiago-Garcia, A.P.; Ramirez-Villafaña, M.; Gonzalez-Ponce, F.; Gomez-Camarena, J.J.; Saldaña-Cruz, A.M.; et al. Intravenous Vitamin C as an Add-on Therapy for the Treatment of Sepsis in an Intensive Care Unit: A Prospective Cohort Study. Medicina 2024, 60, 464. https://doi.org/10.3390/medicina60030464

AMA Style

Gonzalez-Vazquez SA, Gomez-Ramirez EE, Gonzalez-Lopez L, Gamez-Nava JI, Peraza-Zaldivar JA, Santiago-Garcia AP, Ramirez-Villafaña M, Gonzalez-Ponce F, Gomez-Camarena JJ, Saldaña-Cruz AM, et al. Intravenous Vitamin C as an Add-on Therapy for the Treatment of Sepsis in an Intensive Care Unit: A Prospective Cohort Study. Medicina. 2024; 60(3):464. https://doi.org/10.3390/medicina60030464

Chicago/Turabian Style

Gonzalez-Vazquez, Sergio Antonio, Eli Efrain Gomez-Ramirez, Laura Gonzalez-Lopez, Jorge Ivan Gamez-Nava, Juan Angel Peraza-Zaldivar, Aline Priscilla Santiago-Garcia, Melissa Ramirez-Villafaña, Fabiola Gonzalez-Ponce, Jose Jorge Gomez-Camarena, Ana Miriam Saldaña-Cruz, and et al. 2024. "Intravenous Vitamin C as an Add-on Therapy for the Treatment of Sepsis in an Intensive Care Unit: A Prospective Cohort Study" Medicina 60, no. 3: 464. https://doi.org/10.3390/medicina60030464

APA Style

Gonzalez-Vazquez, S. A., Gomez-Ramirez, E. E., Gonzalez-Lopez, L., Gamez-Nava, J. I., Peraza-Zaldivar, J. A., Santiago-Garcia, A. P., Ramirez-Villafaña, M., Gonzalez-Ponce, F., Gomez-Camarena, J. J., Saldaña-Cruz, A. M., Rodriguez-Jimenez, N. A., Gutierrez-Aceves, J. A., Jimenez-Lopez, A., Totsuka-Sutto, S. E., Cardona-Muñoz, E. G., & Ponce-Guarneros, J. M. (2024). Intravenous Vitamin C as an Add-on Therapy for the Treatment of Sepsis in an Intensive Care Unit: A Prospective Cohort Study. Medicina, 60(3), 464. https://doi.org/10.3390/medicina60030464

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