Following up on Dr. Seheult’s lecture, Vasopressors and Vitamin C in Sepsis Explained Clearly, we’ve got new information on the controversy of vitamin C in sepsis treatment.
The Marik Protocol and Resulting Controversy
In our previous video, as well as our series on vasopressors and shock and sepsis, Dr. Seheult described the polarizing study by Paul Marik, which looked at the use of vitamin C to treat sepsis. The study employed Marik’s protocol of vitamin C, hydrocortisone, and thiamine, and although it decreased mortality from 40.4 to 8.5 percent, it also drew loads of criticism for not being a randomized, placebo-controlled trial.
What We Know Now About Vitamin C and Sepsis Treatment
Since the Marik study, a randomized controlled trial (RCT) was released, called the CITRIS-ALI trial, in The Journal of the American Medical Association (JAMA). This new study looked at a larger number of patients who were given either a placebo or vitamin C not just during septic shock, but also after the onset of ARDS, or acute respiratory distress syndrome.
In sum, this study was intended to study ARDS and not just sepsis, so the interpretation of the results gets a little tricky. Patients given vitamin C did experience a significant drop in mortality, however, the CITRIS-ALI trial was not designed to look at mortality as a primary endpoint… and so the debate over vitamin C’s efficacy in treating septic shock ensues.
The Full MedCram Update on Vitamin C and Septic Shock
For the full interpretation and explanation of the CITRIS-ALI trial and the updated picture on using vitamin C for sepsis, check out our video, Sepsis Treatment & Vitamin C – Trials & Updates (Septic Shock) now. Keep following along, as we anticipate more information on this topic to be released soon!