Phase 2 Vitamin C Sepsis Trials: Another Brick in the (Evidence) Wall?

• Authors: Ankita Agarwal, Emory University; Simon Oczkowski, McMaster University; Jonathan Sevransky, Emory University
• Journal Title: CRITICAL CARE MEDICINE
• Volume: Volume 50, Number 5
• Publisher: LIPPINCOTT WILLIAMS & WILKINS | 2022-05-01, Pages 897-899
• Type of Work: Article | Post-print: After Peer Review
• Publisher DOI: http://doi.org/10.1097/CCM.0000000000005432
• Subjects: Health Sciences, Medicine and Surgery
• Keywords: Science & Technology; Life Sciences & Biomedicine; Critical Care Medicine; General & Internal Medicine; ascorbic acid; clinical trial; sepsis; septic shock; treatment guidelines; CAMPAIGN INTERNATIONAL GUIDELINES; RANDOMIZED CONTROLLED-TRIALS; SEPTIC SHOCK; ASCORBIC-ACID; HYDROCORTISONE; MANAGEMENT; THIAMINE; ILL

Abstract

Vitamin C (in the form of citrus fruit) was used in one of the earliest clinical trials when James Lind divided 12 sailors into groups to test the effect of citrus in those with scurvy (1). Clinicians and researchers now have more numerous and sophisticated trial designs and critical appraisal techniques they can use to determine how best to treat patients. Randomized controlled trials (RCTs) serve as the gold standard in clinical trials, and systematic reviews and meta-analyses (SRMAs) incorporating multiple large, high-quality RCTs are considered by many to be the most trustworthy sources of evidence (2).