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Table 1 A summary of recent meta-analysis of vitamin C administration in critical care patients

From: Vitamin C administration in the critically ill: a summary of recent meta-analyses

Publication detailsTitleSelection criteria (PICO)Included studiesSubgroup analysisFindings
Putzu et al. [3]
Crit Care Med
The effect of vitamin C on clinical outcome in critically ill patients: A systematic review with meta-analysis of randomised controlled trialsP—adult critically ill patients
I—vitC (any regimen)
C—placebo or no therapy
O—mortality, acute kidney injury, supraventricular arrhythmia, ventricular arrhythmia, stroke, ICU LOS, hospital LOS
44 RCTs:
16 in ICU setting (n = 2857)
28 in cardiac surgery (n = 3598)
Mixed ICU vs burns vs sepsis/septic shock vs acute pancreatitis
VitC alone vs enteral vitC vs IV vitC vs IV vitC > 5 g
ICU patients:
X mortality
X acute kidney injury
X ICU or hospital LOS
Cardiac surgery:
↓ postoperative atrial fibrillation
↓ ICU and hospital LOS
Wang et al. [4]
Ann Intensive Care
Effects of different ascorbic acid doses on the mortality of critically ill patients: a meta-analysisP—critically ill patients
I—IV vitC (including co-administration of antioxidants)
C—placebo or no intervention
O—mortality, resuscitation fluid requirement, urine output, acute kidney injury, vasopressor requirement, duration of mechanical ventilation, ICU and/or hospital LOS
12 RCT, quasi-RCT, observational (n = 1210)Low dose vs medium dose vs high dose
Burn vs sepsis vs others
↓ mortality (doses of 3–10 g/day)
X morality (< 3 g/day or ≥ 10 g/day)
↓ duration of vasopressor support
↓ duration of mechanical ventilation
X acute kidney injury
X ICU or hospital LOS
X fluid requirement
X urine output
Hemila and Chalker [5]Vitamin C can shorten the length of stay in the ICU: A meta-analysisP—ICU patients
I—vitC
C—placebo or none
O—ICU LOS, duration of mechanical ventilation
18 controlled trials (n = 2004)
including 13 cardiac surgery
IV vs oral
1–2 days ICU vs 3–5 days ICU
> 24 h ventilation vs < 24 h ventilation
↓ ICU LOS
↓ duration of mechanical ventilation
Langlois et al. [6]
JPEN
Vitamin C supplementation in the critically ill: A systematic review and meta-analysisP—ICU patients
I—vitC (enteral or parenteral)
C—placebo or none
O—mortality, incident infections, ICU LOS, hospital LOS, duration of mechanical ventilation
11 RCTs
9 RCTs with mortality (n = 1322)
Low dose vs high dose
Combined therapy vs monotherapy
Oral/enteral vs parenteral
Non-septic vs septic
Higher-quality trials vs low-quality trials
X mortality
↓ (trend) mortality (IV high dose vitC monotherapy)
X infections
X ICU or hospital LOS
X duration of mechanical ventilation
Zhang and Jativa [7]
SAGE Open Med
Vitamin C supplementation in the critically ill: A systematic review and meta-analysisP—critically ill adult patients
I—IV vitC
C—placebo or no intervention
O—mortality, duration of mechanical ventilation, duration of vasopressor support, fluid requirements, urine output
4 RCTs and 1 retrospective (n = 142) X mortality
↓ need for vasopressor support
↓ duration of mechanical ventilation
↓ (trend) fluid requirements
↑ (trend) urine output
Li
Crit Care [1]
Evidence is stronger than you think: a meta-analysis of vitamin C use in patients with sepsisP—patients with sepsis
I—IV vitC
C—placebo or none
O—mortality, ICU LOS, vasopressor duration
2 RCTs and 1 before-after ↓ mortality
X ICU LOS
↓ vasopressor duration
Lin et al. [8]
Open J Intern Med
Adjuvant administration of vitamin C improves mortality of patients with sepsis and septic shock: A systems review and meta-analysisP—patients with septic shock and severe sepsis
I—vitC
C—placebo
O—mortality
4 RCTs and 2 retrospective studies (n = 109)RCT vs retrospective
High dose vs low dose
X mortality
↓ mortality (doses of > 50 mg/kg/day)
X ICU LOS
  1. ICU intensive care unit, IV intravenous, LOS length of stay, PICO patients, intervention, comparator, outcome, RCT randomized controlled trial, vitC vitamin C