Efficacy of Using High-Dose Vitamin C, Thiamine, and Hydrocortisone in Sepsis and Septic Shock: A Retrospective Before-After Study

Abstract Background/Objective Sepsis can be associated with increased production of reactive oxygen species that deplete antioxidant molecules and increase the consumption of vitamin C, which correlates with multiorgan failure and death. Intravenous vitamin C may protect several microvascular functions, including capillary blood flow, microvascular permeability barrier, and arteriolar responsiveness to vasoconstrictors and vasodilators. This study was conducted to assess the practice of administering high-dose vitamin C in critically ill patients with sepsis or septic shock at our institution retrospectively.Methods We conducted an electronic health record (EHR)-based, retrospective, before-after study. The primary objective was to assess the efficacy of using a high-dose vitamin C regimen in decreasing hospital mortality. A two-sided P-value of < 0.05 was considered statistically significant.Results A total of 84 patient records were included in this study. Administration of high-dose vitamin C, thiamine, and hydrocortisone was associated with higher hospital mortality (64.3% versus 42.9%; P = 0.049), higher ICU mortality (59.5% versus 42.9%; P = 0.07), shorter ICU length of stay (three versus seven days; P = 0.53), higher incidence of acute kidney injury (61.9% versus 26.2%; P = 0.001), and a higher requirement for renal replacement therapy (76.9% versus 45.5%; P = 0.06).Conclusion Administration of high-dose vitamin C, thiamine, and hydrocortisone in critical care patients with sepsis or septic shock was associated with higher hospital mortality and higher incidence of acute kidney injury.