Sepsis and intravenous vitamin C

Sepsis is an inflammatory response to infection which can lead to septic shock, multiple organ failure and death. This is an emergency condition treated in hospital intensive care units (ICUs) rather than GP clinics. However, the research on sepsis can reassure all doctors about treating less serious inflammation and infections.

Intravenous vitamin C results

Vitamin C has useful anti-oxidant, anti-inflammatory, immune-supportive, and tissue repair roles. Patients in an ICU – and particularly those with sepsis – often have very low levels of vitamin C in their bloodstream because it is depleted by illness and stress.

A phase I trial has shown that intravenous vitamin C can reduce the extent of multiple organ failure and biomarkers of inflammation and endothelial injury.2

Two other trials have shown a dramatic improvement in mortality.3,4 Dr Paul Marik generated much discussion in medical circles by subsequently deciding to treat sepsis in his ICU with vitamin C, hydrocortisone, and thiamine without waiting for further research.

Vasopressors like norepinephrine are often given to treat septic shock. Vitamin C helps the body produce its own vasopressors. A randomised controlled trial showed reduced mortality, dose and duration of a vasopressor drug when intravenous vitamin C was also administered.4

New Zealand research

Associate Professor Anitra Carr is currently leading a team of researchers from Otago University to study the effect of intravenous vitamin C on sepsis in Christchurch Hospital’s intensive care unit. Their research includes the vasopressor-related effects of IVC as an adjunct to conventional treatment.1

Clinical Guidance

We have supported a range of doctors treating sepsis and infections with intravenous vitamin C. Contact our medical team for assistance.

References

  1. Carr A. C., Shaw G. M., Fowler A. A., Natarajan R. Ascorbate-dependent vasopressor synthesis: a rationale for vitamin C administration in severe sepsis and septic shock? Critical care. 2015;19:418. Available online: http://dx.doi.org/10.1186/s13054-015-1131-2
  2. Fowler 3rd A. A., Syed A. A., Knowlson S., Sculthorpe R., Farthing D., Dewilde C., et al. Phase I safety trial of intravenous ascorbic acid in patients with severe sepsis. J Transl Med. 2014;12(1):32. Available online: http://dx.doi.org/10.1016/j.chest.2016.11.036
  3. Marik P. E., Khangoora V., Rivera R., Hooper M. H., Catravas J. Hydrocortisone, Vitamin C, and Thiamine for the Treatment of Severe Sepsis and Septic Shock: A Retrospective Before-After Study. Chest. 2017;151:1229-1238. Available online: http://dx.doi.org/10.4103/2279-042X.179569
  4. Zabet M. H., Mohammadi M., Ramezani M., Khalili H. Effect of high-dose Ascorbic acid on vasopressor’s requirement in septic shock. J Res Pharm Pract. 2016;5(2):94-100. Available online: http://dx.doi.org/10.1186/1479-5876-12-32