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Vitamin therapy in sepsis.

Eric L Wald1, Colleen M Badke2, Lauren K Hintz3

  • 1Division of Critical Care, Ann & Robert H. Lurie Children's Hospital of Chicago and Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. ewald@luriechildrens.org.

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Summary
This summary is machine-generated.

Vitamins play crucial roles in sepsis. While vitamin C shows promise in some adult studies, evidence for other vitamins in sepsis remains mixed, necessitating further research.

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Area of Science:

  • Critical care medicine
  • Nutritional science
  • Biochemistry

Background:

  • Vitamins are essential micronutrients involved in biological pathways crucial for sepsis management.
  • Plasma vitamin deficiencies are common in sepsis, and vitamin therapy has shown potential for improved outcomes.
  • Vitamin C is the most studied vitamin in adult sepsis, with mixed results depending on administration as monotherapy or combination therapy.

Purpose of the Study:

  • To review preclinical, clinical, and safety evidence of key vitamins (C, B1, D, A, B2, B6, B12, E) in sepsis.
  • To summarize the current understanding of vitamin roles in sepsis for both pediatric and adult populations.
  • To identify knowledge gaps and suggest future research directions for vitamin therapy in critical illness.

Main Methods:

  • Narrative review of existing literature on vitamin use in sepsis.
  • Analysis of randomized control trials (RCTs) for vitamin C monotherapy and combination therapy in adult sepsis.
  • Inclusion of studies on other vitamins (A, B1, B2, B6, B12, D, E) in pediatric and adult sepsis and critical illness.

Main Results:

  • High-dose intravenous vitamin C monotherapy in adults showed reduced organ dysfunction and mortality.
  • Combination therapy with vitamin C, thiamine, and hydrocortisone did not demonstrate improved clinical outcomes in adults.
  • Evidence for other vitamins in sepsis remains mixed, with varying preclinical and clinical data.

Conclusions:

  • Vitamins are vital in biological processes relevant to sepsis.
  • Further research, potentially through response-adaptive platform trials, is needed to clarify the role of various vitamins in sepsis and critical illness.
  • Targeted vitamin supplementation strategies may improve outcomes in sepsis, but require more robust evidence.