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Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Crit Care Med. Oct 16, 2018; 7(5): 52-61
Published online Oct 16, 2018. doi: 10.5492/wjccm.v7.i5.52
Vitamin C in the critically ill - indications and controversies
Christoph S Nabzdyk, Edward A Bittner
Christoph S Nabzdyk, Edward A Bittner, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States
Author contributions: Both authors equally contributed to this paper with conception, literature review, drafting and critical revision and editing, and final approval of the final version.
Conflict-of-interest statement: No potential conflicts of interest. No financial support.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Edward A Bittner, MD, PhD, MSEd, Associate Professor, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA 02114, United States. ebittner@partners.org
Telephone: +1-617-7263030 Fax: +1-617-7267536
Received: June 24, 2018
Peer-review started: June 25, 2018
First decision: July 9, 2018
Revised: August 4, 2018
Accepted: August 21, 2018
Article in press: August 21, 2018
Published online: October 16, 2018
Abstract

Ascorbic acid (vitamin C) elicits pleiotropic effects in the body. Among its functions, it serves as a potent anti-oxidant, a co-factor in collagen and catecholamine synthesis, and a modulator of immune cell biology. Furthermore, an increasing body of evidence suggests that high-dose vitamin C administration improves hemodynamics, end-organ function, and may improve survival in critically ill patients. This article reviews studies that evaluate vitamin C in pre-clinical models and clinical trials with respect to its therapeutic potential.

Keywords: Ascorbic acid, vitamin C, Sepsis, Shock, Critical care medicine, Vasopressors, Cardiovascular

Core tip: An increasing body of evidence suggests that high-dose vitamin C administration improves hemodynamics, end-organ function, and may improve survival in critically ill patients. This article reviews studies that evaluate vitamin C in pre-clinical models and clinical trials with respect to its therapeutic potential.