Purpose: Sepsis has high incidence and mortality rates, particularly in the intensive care unit (ICU). Corticosteroids may improve outcomes, and vitamin C may add benefit . We aimed to assess whether vitamin C and corticosteroids improved outcomes compared with corticosteroids alone .
Methods: This historical cohort study (11 December 2016 to 21 February 2018) was conducted in the ICU of a quaternary referral hospital . Patients with an ICU admission diagnosis of sepsis or septic shock who received vitamin C and hydrocortisone within 72 hr were compared with those who received only hydrocortisone . All patients received standard sepsis care including source control, antibiotics, and fluid resuscitation . Most patients received thiamine as standard ICU care . The primary outcome was hospital mortality . Secondary outcomes included ICU mortality, ventilator-free days, vasopressor-free days, dialysis use, and duration of ICU admission .
Results: One hundred and forty-four patients were included in the study . The mean (standard deviation [SD] ) age was 64 (15) yr; 39% were female; and the mean (SD) Acute Physiology And Chronic Health Evaluation IV score was 89 (30). Eighty-eight patients did not receive vitamin C and 52 received vitamin C. There was no observed difference in hospital mortality between the non-vitamin C (36 %) and vitamin C (39 %) groups (adjusted odds ratio for hospital death, 0.52; 95% confidence interval , 0.20 to 1.34; P = 0.18). There were no statistically significant differences in any secondary outcomes . Conclusion: In this small observational study of ICU patients with septic shock, the addition of vitamin C to hydrocortisone therapy did significantly affect hospital mortality or other measures of mortality or organ dysfunction.