A Comparison of the Efficacy of High-Dose Vitamin C Infusion and Thiamine (Vitamin B1) Infusion in Patients With Sepsis: A Prospective Randomized Controlled Trial

高剂量维生素C输注与硫胺素(维生素B1)输注治疗脓毒症患者疗效的比较:一项前瞻性随机对照试验

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Abstract

Background and objective Vitamin C and thiamine possess properties that may mitigate the harmful effects of sepsis. However, there is a dearth of studies in the literature comparing these two vitamins with each other and with a placebo regarding their efficacy against sepsis. This study aimed to investigate the outcomes associated with high-dose infusions of vitamin C and thiamine in septic patients, thereby seeking to contribute valuable insights into the optimal management of sepsis. The primary objective was to compare the sequential organ failure assessment (SOFA) score and C-reactive protein (CRP) level improvement on Day Six among the vitamin C, thiamine, and placebo groups after the intervention for five days. Methodology This prospective randomized comparative study involved 75 patients. Patients were randomized into three groups of 25 each. The first group received high-dose vitamin C infusion along with standard treatment for sepsis; the second group received high-dose thiamine infusion along with standard treatment for sepsis; and the third group, the placebo group, received only standard treatment for sepsis for five days. The SOFA score, CRP level, and other parameters were evaluated on Day Six. Results The SOFA score (p=0.043) and CRP level (p=0.0161) on Day Six were lower in the vitamin C group than in the placebo group. The CRP level on Day Six was significantly lower in the thiamine group than in the placebo group (p=0.016). The duration of vasopressor therapy was significantly lower in the vitamin C group than in the placebo group (p=0.0276) and the thiamine group (p=0.0236). Conclusions Based on our findings, vitamin C infusion helps improve the SOFA score and CRP level in sepsis patients. It can also decrease the duration of vasopressor therapy and serious adverse events whereas thiamine can reduce CRP levels in these patients.

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