Table 3 Controlled studies on the effect of vitamin C in critically ill patients

Nathens and colleagues [104]

RCT; trauma and MOF

i.v. vitamin C 1 g three times daily; enteral vitamin E 1,000 IU three times daily

301

Pulmonary morbidity ↓, new MOF ↓, LOS ventilation ↓, LOS ICU ↓

With TPN, vitamin C 100 mg and vitamin E 10 IU daily; with EN, vitamin C 340 mg/l, vitamin E 60 IU/l

294

Crimi and colleagues [107]

RCT; critically ill (mainly trauma, cardiogenic shock)

Vitamin C 500 mg/day and vitamin E (400 IU/day) in EN

105

Ventilator-free days ↓, 28-day mortality ↓

Saline solution for 10 days

111

Collier and colleagues [103]

Prospective vs. retrospective 1-year cohort; trauma

i.v. or oral vitamin C 1 g three times daily + oral vitamin E 1,000 IU three times daily + selenium 200 μg i.v.

2,272

LOS ICU ↓, LOS hospital ↓, mortality ↓; OR 0.32, 95 % CI 0.22 to 0.46

Standard therapy

2,022

Berger and colleagues [105]

RCT; complicated cardiac surgery, trauma, SAB

Selenium 540 i.v. day 1, 270 μg days 2 to 5; zinc 60 mg i.v. day 1, 30 mg days 2 to 5; vitamin B1 305 mg i.v. day 1, 205 mg days 2 to 5; vitamin C 2.7 g i.v. day 1, 1.6 g days 2 to 5; vitamin E 600 mg i.v. day 1, 300 mg days 2 to 5

102

New organ failure ND, new infections ND, LOS shorter in trauma, CRP ↓ in cardiac surgery and trauma, recovery of health after discharge ↑

Vitamin B1 100 mg i.v. days 1 to 3 (both groups); vitamin C 500 mg i.v. days 1 to 5 (both groups)

98

Heyland and colleagues [106]

RCT, 2 × 2 factorial; critically ill adults with multiple organ failure

Selenium 500 μg i.v., selenium 300 μg or zinc 20 mg or β-carotene 10 mg; vitamin E 500 mg or vitamin C 1,500 mg

307

No difference in 28-day mortality or length of stay

Burn

Placebo

300

Tanaka and colleagues [84]

RCT; severe burn <2 hours

Ringer lactate + 66 mg/kg/hour vitamin C

19

Fluid requirements ↓, body weight gain ↓, PF ratio ↑, days on mechanical ventilation ↓

Ringer lactate for 24 hours

18

Kahn and colleagues [85]

Retrospective; severe burn <10 hours

Ringer lacate + 66 mg/kg/hour vitamin C

17

Fluid requirements ↓, urinary output ↑

Ringer lactate for 24 hours

16