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POSTED: June 27th, 2021
POSTED IN: EM Pulse - The Official Newsletter of MOCEP, May/June 2021,

In 2018, MOCEP provided funds toward a research grant titled “Serum Vitamin C in Septic Patients Presenting to the Emergency Department.” The research was performed by Vincent Manning, MD; Christopher Sampson, MD, FACEP; and Joshua Stilley, MD, all of the University of Missouri – Columbia. The following is a summary of the research project and its findings.

Sepsis is defined as a dysregulated host response to infection. Over the years, there have been multiple advancements in the treatment of sepsis, and now the hallmarks of treatment depend on early recognition, antibiotic therapy, and fluid resuscitation. 

Recently, Marik et al published a study in Chest which studied the effect of hydrocortisone, vitamin C, and thiamine in septic patients. It resulted in a significant improvement in mortality and has subsequently led to significant interest in the role of vitamin C as an adjunct therapy in the treatment of sepsis. The findings suggest that patients who develop sepsis may have low serologic levels of vitamin C and thus benefit from supplementation.

We performed a prospective case-control study at a level I trauma center in Mid-Missouri with >25,000 admissions per year. All non-pregnant adult patients older than 18 who were admitted to the surgical or medical ICU were eligible for inclusion. The vitamin C level at admission and at 72hrs was obtained. We compared equal numbers of septic and non-septic patients, and evaluated for any association with adverse outcomes, including length of stay and mortality.

Total # of completed tests	19
Age	64.5
Number M	13
Number F	6
Number Suspected Sepsis	7

The only statistical difference was comparing vitamin C levels in all comers to the ED vs. all comers 72 hours after admission (mostly in the ICU) p=0.02

No differences were found when looking at sepsis during any time point to other ICU admissions during any time point p=0.61

Or when comparing all groups (including healthy volunteers) p=.20