Update on vitamin C administration in critical illness

source extracted confidence: high 2026-04-09
#animals #ascorbic-acid #critical-illness #humans #hydrocortisone

Update on vitamin C administration in critical illness

Fujii et al., 2022 | Curr Opin Crit Care | Narrative Review

Citation

Fujii Tomoko, Lankadeva Yugeesh R, Bellomo Rinaldo. Update on vitamin C administration in critical illness. Curr Opin Crit Care. 2022-Aug-01;28(4):374-380. doi:10.1097/MCC.0000000000000951

Abstract

PURPOSE OF REVIEW: Several studies have recently explored the effects of intravenous vitamin C in sepsis. We aimed to summarize their findings to provide perspectives for future research. RECENT FINDINGS: Sepsis trials examined 6 g/day of intravenous vitamin C with or without the thiamine and/or hydrocortisone compared with placebo or hydrocortisone. Network meta-analysis reported that intravenous vitamin C, thiamine, hydrocortisone, or combinations of these drugs was not proven to reduce long-term mortality. However, the component network meta-analysis suggested an association of high-dose (>6 g/day) and very-high dose vitamin C (>12 g/day) and decreased mortality but with low certainty. The preclinical investigations have, however, advanced to much higher doses of intravenous vitamin C therapy since a scoping review on harm reported that mega-doses of intravenous vitamin C (50-100 g/day) had been administered without any conclusive adverse effects. In a Gram-negative sheep model, renal tissue hypoperfusion was reversed, followed by improvements in kidney function when a mega-dose of vitamin C (150 g/day equivalent) was administered. SUMMARY: The effect of intravenous vitamin C in critically ill patients has yet to be determined and might be dose-dependent. Clinical studies of very high or mega doses of vitamin C are justified by preclinical data.

Key Findings

Sepsis trials examined 6 g/day of intravenous vitamin C with or without the thiamine and/or hydrocortisone compared with placebo or hydrocortisone. Network meta-analysis reported that intravenous vitamin C, thiamine, hydrocortisone, or combinations of these drugs was not proven to reduce long-term mortality. However, the component network meta-analysis suggested an association of high-dose (>6 g/day) and very-high dose vitamin C (>12 g/day) and decreased mortality but with low certainty. The pre

Outcomes Measured

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Population

Field Value
Population See abstract
Sample Size See abstract
Age Range See abstract
Condition See abstract

MeSH Terms

  • Animals
  • Ascorbic Acid
  • Critical Illness
  • Humans
  • Hydrocortisone
  • Sepsis
  • Sheep
  • Thiamine
  • Vitamins

Evidence Classification

  • Level: Narrative Review
  • Publication Types: Journal Article, Review, Network Meta-Analysis
  • Vertical: vitamin-c

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09