دوره 31، شماره 147 - ( 5-1402 )                   جلد 31 شماره 147 صفحات 371-364 | برگشت به فهرست نسخه ها


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Karami A, Fallahpour F, Motamed N, Jafari M R. Evaluation of the Effects of Vitamin C in Prognosis of Patients with Sepsis in Zanjan Vali- e-Asr Hospital in 2020. J Adv Med Biomed Res 2023; 31 (147) :364-371
URL: http://journal.zums.ac.ir/article-1-6980-fa.html
Evaluation of the Effects of Vitamin C in Prognosis of Patients with Sepsis in Zanjan Vali- e-Asr Hospital in 2020. Journal of Advances in Medical and Biomedical Research. 1402; 31 (147) :364-371

URL: http://journal.zums.ac.ir/article-1-6980-fa.html


چکیده:   (1247 مشاهده)

Background and Objective: Regarding the high prevalence of sepsis, it is important to discover methods to control this condition. Valuable effect of vitamin C in vasopressin synthesis is demonstrated, moreover, its antioxidant effect reduces vascular infiltration. Therefore, the beneficial effects of vitamin C in prognosis of the patients who have been admitted to Vali-e- Asr hospital in Zanjan, Iran with the diagnosis of sepsis have been evaluated.
Materials and Methods: This cross sectional study was planned on patients with sepsis who have been admitted to the infectious ward of Vali-e-Asr hospital in Zanjan. Patients with sepsis above 18 years old from June to March 2020 have been included in this study. Data of patients whom have received intravenous vitamin C, 25 mg/kg/24h for 4 days, and patients without reception vitamin C was collected from their files. Their demographic, clinical and para clinical information were collected, then the information was analyzed.
Results: 54 patients (26 received vitamin C and 28 did not receive vitamin C) were enrolled in this study. Considering that the two groups were matched from the beginning of the study, no statistically significant difference was found between the two groups of patients in demographic characteristics. Furthermore, there were no significant differences in the sepsis induced complications, e.g. laboratory findings, mean days of hospitalization in ICU and SOFA score.
Conclusion: Our findings demonstrated that no clear statistically significant difference was found between the two groups of control and vitamin C received groups; nonetheless for precise conclusion more studies with larger groups are required.

متن کامل [PDF 341 kb]   (517 دریافت)    
نوع مطالعه: کارآزمایی بالینی | موضوع مقاله: Clinical medicine
دریافت: 1401/8/26 | پذیرش: 1402/1/5 | انتشار: 1402/7/5

فهرست منابع
1. Zhang YY, Ning BT. Signaling pathways and intervention therapies in sepsis. Signal Transduct Target Ther. 2021;6(1):407. [DOI:10.1038/s41392-021-00816-9] [PMID] [PMCID]
2. Singer M, Deutschman CS, Seymour CW, et al. The third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA. 2016;315(8):801-10. [DOI:10.1001/jama.2016.0287] [PMID] [PMCID]
3. Goldstein B, Giroir B, Randolph A. International consensus conference on pediatrics. International pediatric sepsis consensus conference: definitions for sepsis and organ dysfunction in pediatrics. Pediatr Crit Care Med. 2005;6(1):2-8. [DOI:10.1097/01.PCC.0000149131.72248.E6] [PMID]
4. Fleischmann C, Scherag A, Adhikari NK, et al. Assessment of global incidence and mortality of hospital-treated sepsis. Current estimates and limitations. Am J Respir Crit Care Med. 2016;193(3):259-72. [DOI:10.1164/rccm.201504-0781OC] [PMID]
5. Becker JU, Theodosis C, Jacob ST, Wira CR, Groce NE. Surviving sepsis in low-income and middle-income countries: new directions for care and research. Lancet Infect Dis. 2009;9(9):577-82. [DOI:10.1016/S1473-3099(09)70135-5] [PMID]
6. van den Boogaard W, Manzi M, Harries AD, Reid AJ. Causes of pediatric mortality and case-fatality rates in eight Medecins Sans Frontieres-supported hospitals in Africa. Public Health Action. 2012;2(4):117-21. [DOI:10.5588/pha.12.0038] [PMID] [PMCID]
7. Rudd KE, Johnson SC, Agesa KM, et al. Global, regional, and national sepsis incidence and mortality, 1990-2017: analysis for the Global Burden of Disease Study. Lancet. 2020;395(10219):200-11. [DOI:10.1016/S0140-6736(19)32989-7] [PMID]
8. Kim JY, Lee SM. Effect of ascorbic acid on hepatic vasoregulatory gene expression during polymicrobial sepsis. Life Sci. 2004;75(16):2015-26. [DOI:10.1016/j.lfs.2004.06.002] [PMID]
9. Timimi FK, Ting HH, Haley EA, Roddy MA, Ganz P, Creager MA. Vitamin C improves endothelium-dependent vasodilation in patients with insulin-dependent diabetes mellitus. J Am Coll Cardiol. 1998;31(3):552-7. [DOI:10.1016/S0735-1097(97)00536-6]
10. Ting HH, Timimi FK, Boles KS, Creager SJ, Ganz P, Creager MA. Vitamin C improves endothelium-dependent vasodilation in patients with non-insulin-dependent diabetes mellitus. J Clin Invest. 1996;97(1):22-8. [DOI:10.1172/JCI118394] [PMID] [PMCID]
11. Solzbach U, Hornig B, Jeserich M, Just H. Vitamin C improves endothelial dysfunction of epicardial coronary arteries in hypertensive patients. Circulation. 1997;96(5):1513-9. [DOI:10.1161/01.CIR.96.5.1513] [PMID]
12. Jackson WF. The endothelium-derived relaxing factor. J Reconstr Microsurg. 1989;5(3):263-71. [DOI:10.1055/s-2007-1006876] [PMID]
13. Tyml K, Li F, Wilson JX. Septic impairment of capillary blood flow requires nicotinamide adenine dinucleotide phosphate oxidase but not nitric oxide synthase and is rapidly reversed by ascorbate through an endothelial nitric oxide synthase-dependent mechanism. Crit Care Med. 2008;36(8):2355-62. [DOI:10.1097/CCM.0b013e31818024f6] [PMID] [PMCID]
14. Naseem KM. The role of nitric oxide in cardiovascular diseases. Mol Aspects Med. 2005;26(1-2):33-65. [DOI:10.1016/j.mam.2004.09.003] [PMID]
15. De Cruz SJ, Kenyon NJ, Sandrock CE. Bench-to-bedside review: the role of nitric oxide in sepsis. Expert Rev Respir Med. 2021;(5)3:9. [DOI:10.1586/ers.09.39] [PMID]
16. Parratt JR. Nitric oxide in sepsis and endotoxaemia. J Antimicrob Chemother. 1998;41 Suppl A:31-9. [DOI:10.1093/jac/41.suppl_1.31] [PMID]
17. Wu F, Tyml K, Wilson JX. Ascorbate inhibits iNOS expression in endotoxin- and IFN gamma-stimulated rat skeletal muscle endothelial cells. FEBS Lett. 2002;520(1-3):122-6. [DOI:10.1016/S0014-5793(02)02804-1] [PMID]
18. Wu F, Wilson JX, Tyml K. Ascorbate inhibits iNOS expression and preserves vasoconstrictor responsiveness in skeletal muscle of septic mice. Am J Physiol Regul Integr Comp Physiol. 2003;285(1):R50-6. [DOI:10.1152/ajpregu.00564.2002] [PMID]
19. Ulker S, McKeown PP, Bayraktutan U. Vitamins reverse endothelial dysfunction through regulation of eNOS and NAD(P)H oxidase activities. Hypertension. 2003;41(3):534-9. [DOI:10.1161/01.HYP.0000057421.28533.37] [PMID]
20. Keel M, Trentz O. Pathophysiology of polytrauma. Injury. 2005;36(6):691-709. [DOI:10.1016/j.injury.2004.12.037] [PMID]
21. Rossig L, Hoffmann J, Hugel B, et al. Vitamin C inhibits endothelial cell apoptosis in congestive heart failure. Circulation. 2001;104(18):2182-7. [DOI:10.1161/hc4301.098284] [PMID]
22. Saeed RW, Peng T, Metz CN. Ascorbic acid blocks the growth inhibitory effect of tumor necrosis factor-alpha on endothelial cells. Exp Biol Med (Maywood). 2003;228(7):855-65. [DOI:10.1177/15353702-0322807-12] [PMID]
23. Fiorito C, Rienzo M, Crimi E, et al. Antioxidants increase number of progenitor endothelial cells through multiple gene expression pathways. Free Radic Res. 2008;42(8):754-62. [DOI:10.1080/10715760802357057] [PMID]
24. Mo SJ, Son EW, Rhee DK, Pyo S. Modulation of TNF-alpha-induced ICAM-1 expression, NO and H2O2 production by alginate, allicin and ascorbic acid in human endothelial cells. Arch Pharm Res.2003;26(3):244-51. [DOI:10.1007/BF02976837] [PMID]
25. Martin WJ. Neutrophils kill pulmonary endothelial cells by a hydrogen-peroxide-dependent pathway. An in vitro model of neutrophil-mediated lung injury. Am Rev Respir Dis. 1984;130(2):209-13. [DOI:10.1164/arrd.1984.130.2.209] [PMID]
26. Chen YH, Lin SJ, Chen YL, Liu PL, Chen JW. Anti-inflammatory effects of different drugs/agents with antioxidant property on endothelial expression of adhesion molecules. Cardiovasc Hematol Disord Drug Targets. 2006;6(4):279-304. [DOI:10.2174/187152906779010737] [PMID]
27. May JM, Qu ZC. Ascorbic acid prevents increased endothelial permeability caused by oxidized low density lipoprotein. Free Radic Res. 2010;44(11):1359-68. [DOI:10.3109/10715762.2010.508496] [PMID] [PMCID]
28. Wilson JX. Mechanism of action of vitamin C in sepsis: ascorbate modulates redox signaling in endothelium. Biofactors. 2009;35(1):5-13. [DOI:10.1002/biof.7] [PMID] [PMCID]
29. Utoguchi N, Ikeda K, Saeki K, et al. Ascorbic acid stimulates barrier function of cultured endothelial cell monolayer. J Cell Physiol. 1995;163(2):393-9. [DOI:10.1002/jcp.1041630219] [PMID]
30. Levine M, Conry-Cantilena C, Wang Y, et al. Vitamin C pharmacokinetics in healthy volunteers: evidence for a recommended dietary allowance. Proc Natl Acad Sci U S A. 1996;93(8):3704-9. [DOI:10.1073/pnas.93.8.3704] [PMID] [PMCID]
31. Hathcock JN, Azzi A, Blumberg J, et al. Vitamins E and C are safe across a broad range of intakes. Am J Clin Nutr. 2005;81(4):736-45. [DOI:10.1093/ajcn/81.4.736] [PMID]
32. Ichim TE, Minev B, Braciak T, et al. Intravenous ascorbic acid to prevent and treat cancer-associated sepsis? J Transl Med. 2011;9:25. [DOI:10.1186/1479-5876-9-25] [PMID] [PMCID]
33. Wu T, Hu C, Huang W, Xu Q, Hu B, Li J. Effect of combined hydrocortisone, ascorbic acid and thiamine for patients with sepsis and septic shock: A systematic review and meta-analysis. Shock. 2021;56(6):880-9. [DOI:10.1097/SHK.0000000000001781] [PMID]
34. Fisher BJ, Kraskauskas D, Martin EJ, et al. Mechanisms of attenuation of abdominal sepsis induced acute lung injury by ascorbic acid. Am J Physiol Lung Cell Mol Physiol. 2012;303(1):L20-32. [DOI:10.1152/ajplung.00300.2011] [PMID]
35. Fowler AA, Syed AA, Knowlson S, et al. Phase I safety trial of intravenous ascorbic acid in patients with severe sepsis. J Transl Med. 2014;12:32. [DOI:10.1186/1479-5876-12-32] [PMID] [PMCID]
36. Kawade N, Tokuda Y, Tsujino S, et al. Dietary intake of ascorbic acid attenuates lipopolysaccharide-induced sepsis and septic inflammation in ODS rats. J Nutr Sci Vitaminol (Tokyo). 2018;64(6):404-11. [DOI:10.3177/jnsv.64.404] [PMID]
37. Marik PE. Patterns of death in patients with sepsis and the use of hydrocortisone, ascorbic acid, and thiamine to prevent these deaths. Surg Infect (Larchmt). 2018;19(8):812-20. [DOI:10.1089/sur.2018.111] [PMID]
38. Moskowitz A, Andersen LW, Huang DT, et al. Ascorbic acid, corticosteroids, and thiamine in sepsis: a review of the biologic rationale and the present state of clinical evaluation. Crit Care. 2018;22(1):283. [DOI:10.1186/s13054-018-2217-4] [PMID] [PMCID]
39. Moskowitz A, Yankama T, Andersen LW, et al. Ascorbic acid, corticosteroids and thiamine in sepsis (ACTS) protocol and statistical analysis plan: a prospective, multicentre, double-blind, randomised, placebo-controlled clinical trial. BMJ Open. 2019;9(12):e034406. [DOI:10.1136/bmjopen-2019-034406] [PMID] [PMCID]
40. Iglesias J, Vassallo AV, Patel VV, Sullivan JB, Cavanaugh J, Elbaga Y. Outcomes of Metabolic Resuscitation Using Ascorbic Acid, Thiamine, and Glucocorticoids in the early treatment of sepsis: The organes trial. Chest. 2020;158(1):164-73. [DOI:10.1016/j.chest.2020.02.049] [PMID]
41. Kim J, Arnaout L, Remick D. Hydrocortisone, ascorbic acid, and thiamine (HAT) therapy decreases oxidative stress, improves cardiovascular function, and improves survival in murine sepsis. Shock. 2020;53(4):460-7. [DOI:10.1097/SHK.0000000000001385] [PMID]
42. Grossestreuer AV, Moskowitz A, Andersen LW, et al. Effect of ascorbic acid, corticosteroids, and thiamine on health-related quality of life in sepsis. Crit Care Explor. 2020;2(12):e0270. [DOI:10.1097/CCE.0000000000000270] [PMID] [PMCID]
43. Marik PE, Varon J, Surani SR. Hydrocortisone, ascorbic acid and thiamine for sepsis: Is the jury out? World J Diabetes. 2020;11(4):90-4. [DOI:10.4239/wjd.v11.i4.90] [PMID] [PMCID]
44. Assouline B, Faivre A, Verissimo T, et al. Thiamine, ascorbic acid, and hydrocortisone as a metabolic resuscitation cocktail in sepsis: A meta-analysis of randomized controlled trials with trial sequential analysis. Crit Care Med. 2021;49(12):2112-20. [DOI:10.1097/CCM.0000000000005262] [PMID]
45. Fong KM, Au SY, Ng GWY. Steroid, ascorbic acid, and thiamine in adults with sepsis and septic shock: a systematic review and component network meta-analysis. Sci Rep. 2021;11(1):15777. [DOI:10.1038/s41598-021-95386-9] [PMID] [PMCID]
46. Lee YR, Vo K, Varughese JT. Benefits of combination therapy of hydrocortisone, ascorbic acid and thiamine in sepsis and septic shock: A systematic review. Nutr Health. 2022;28(1):77-93. [DOI:10.1177/02601060211018371] [PMID]
47. Litwak JJ, Cho N, Nguyen HB, Moussavi K, Bushell T. Vitamin C, hydrocortisone, and thiamine for the treatment of severe sepsis and septic shock: A retrospective analysis of real-world application. J Clin Med. 2019;8(4). [DOI:10.3390/jcm8040478] [PMID] [PMCID]
48. Iglesias J, Vassallo AV, Liesenfeld O, et al. A 33-mRNA classifier is able to produce inflammopathic, adaptive, and coagulopathic endotypes with prognostic significance: The outcomes of metabolic resuscitation using ascorbic acid, thiamine, and glucocorticoids in the early treatment of sepsis (ORANGES) trial. J Pers Med. 2021;11(1):9. [DOI:10.3390/jpm11010009] [PMID] [PMCID]
49. Zabet MH, 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. [DOI:10.4103/2279-042X.179569] [PMID] [PMCID]
50. Mitchell AB, Ryan TE, Gillion AR, Wells LD, Muthiah MP. Vitamin C and thiamine for sepsis and septic shock. Am J Med. 2020;133(5):635-638. [DOI:10.1016/j.amjmed.2019.07.054] [PMID]
51. Fowler AA, Truwit JD, Hite RD, et al. Effect of vitamin C infusion on organ failure and biomarkers of inflammation and vascular injury in patients with sepsis and severe acute respiratory failure: The CITRIS-ALI randomized clinical trial. JAMA. 2019; 322(13):1261-1270. [DOI:10.1001/jama.2019.11825] [PMID] [PMCID]
52. Moskowitz A, Huang DT, Hou PC, et al.Effect of ascorbic acid, corticosteroids, and thiamine on organ injury in septic shock: The ACTS randomized clinical trial. JAMA. 2020;324(7):642-650. [DOI:10.1001/jama.2020.11946] [PMID] [PMCID]
53. Na W, Shen H, Li Y, Qu D. Hydrocortisone, ascorbic acid, and thiamine (HAT) for sepsis and septic shock: a meta-analysis with sequential trial analysis. J Intensive Care 2021; 9(1):75. [DOI:10.1186/s40560-021-00589-x] [PMID] [PMCID]
54. Rosengrave P, Spencer E, Williman J, et al. Intravenous vitamin C administration to patients with septic shock: a pilot randomised controlled trial. Crit Care. 2022; 26(1):26. [DOI:10.1186/s13054-022-03900-w] [PMID] [PMCID]

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