严重感染患者的亲腔维生素C:系统性审查
Arnav Agarwal1,2, John Basmaji3, Shannon M Fernando4,5
1Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto.
NEJM evidence
|February 6, 2024
概括
在严重感染中补充维生素C并没有显示出明显的生存益处. 证据表明,对90天死亡率和降血糖风险增加的潜在危害,需要谨慎.
科学领域:
- 关键护理医学 关键护理医学
- 营养科学 营养科学
- 基于证据的医学是基于证据的医学.
背景情况:
- 严重的感染会导致炎症和氧化损伤.
- 亲肠道维生素C正在作为一种潜在的治疗干预措施被探索.
研究的目的:
- 系统地审查随机对照试验 (RCT),评估严重感染的成年人内肠道维生素C.
- 评估维生素C对死亡率和其他结果的影响.
主要方法:
- 对41个涉及4915名患者的RCT进行了系统审查和随机效应元分析.
- 主要结局:死亡率 (住院,30天,早期和90天).
- 使用GRADE方法评估证据的确定性.
主要成果:
- 低确定性证据最初表明,减少了早期和30天死亡率.
- 高质量的试验中的灵敏性分析显示了减弱的效果,中等确定性没有医院死亡率的好处.
- 中等确定性证据表明,对90天死亡率和降血糖风险增加的潜在危害.
结论:
- 目前来自RCT的证据并未确定亲肠道维生素C对患有严重感染的患者的生存益处.
- 根据辅助干预措施,剂量或感染类型,没有发现对死亡率的显著子组影响.
- 可能需要进一步的高质量研究来澄清维生素C在严重感染中的作用.
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