Hypovitaminosis C and vitamin C deficiency are very common in critically ill patients. This is due to increased needs and decreased intake. Thus, as vitamin C has pleiotropic functions, its deficiency has serious consequences, such as worsening the severity of the disease and difficulty in recovery. Intravenous vitamin C in pharmacological dose seems to be a promising, well-tolerated and inexpensive adjuvant therapy to modulate overwhelming oxidative stress in severe sepsis, trauma, and reperfusion after ischemia.
Vitamin C supplementation
Many critically ill patients, especially those with oxidative stress, are deficient in vitamin C because the needs are higher and the intake is lower than recommended. An intravenous dose of 2–3 g/day is required to restore normal plasma concentrations, as enteral uptake is insufficient due to maximum enteral absorption capacity.
Several studies suggest less organ failure when vitamin C is administered in a repletion dose. Some recent small controlled studies suggest that vitamin C used in pharmacological doses (6–16 g/day) reduces vasopressor support, accelerates recovery from organ failure, and even reduces mortality. In addition, despite increased oxalate excretion, it indicates improvement in renal function.
So far, vitamin C supplementation seems to be well tolerated, has low cost and is widely available. In addition, it is extremely promising to modulate severe oxidative stress in severe sepsis, trauma and reperfusion after ischemia.
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– Spoelstra-de Man AME, Elbers PWG, Oudemans-Van Straaten HM. Vitamin C: should we supplement?.
Curr Opin Crit Care
. 2018;24(4):248-255. doi:10.1097/MCC.00000000000000510