Effect of vitamin C on coagulation factors and endothelium function in patients with sepsis

Kiumarth Amini; Mojtaba Mojtahedzadeh; Atabak Najafi; Hamidreza Sharifnia; Aliasghar Tabatabaei Mohammadi

doi:10.18502/fem.v7i2.12768

Kiumarth Amini Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
Mojtaba Mojtahedzadeh Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
Atabak Najafi Department of Anaesthesiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Hamidreza Sharifnia Department of Anaesthesiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Aliasghar Tabatabaei Mohammadi Urmia University of Medical Sciences, Urmia, Iran.

DOI: https://doi.org/10.18502/fem.v7i2.12768

Keywords: Acid Ascorbic; Blood Coagulation; Endothelium; Sepsis; Syndecan-1

Abstract

Objective: Sepsis is one of the leading causes of mortality in intensive care unit. Despite advances in its management, its mortality rate remains high. Recently, high dose of vitamin C in sepsis treatment has attracted the attention of researchers. In the current study, the impacts of 25 mg/kg of vitamin C every 6 hours as a bolus for 3 days were assessed in septic patients in intensive care unit (ICU).

Methods: This was a prospective cohort study that was performed on adult patients with diagnosis of sepsis. Patients were assigned to control group (administration of placebo) or intervention group, i.e., those receiving a 25 mg/kg dose of vitamin C every 6 hours as a bolus for 3 days. Clinical data were recorded before and after the experiment. Also, plasma levels of antithrombin III, syndecan-1, fibrin degradation product (FDP), D-dimer, and C-reactive protein (CRP) were measured at 0, 24, 48, and 72 hours.

Results: In septic patients receiving vitamin C, a significant upregulation of antithrombin III and significant decreases in the levels of syndecan-1 (at 48 hours; P-value=0.046 and at 72 hours; P-value=0.007), D-dimer and CRP were observed compared to the control. Reductions in sequential organ failure assessment (SOFA) score, in-hospital mortality, and ICU length of stay were seen in septic patients receiving vitamin C.

Conclusion: Prescribing high dose of intravenous vitamin C can reduce the mortality of sepsis patients and reduce the length of stay in the ICU.