Vitamin C given intravenously is different than orally; it can nfluence the immune system's response to inflammation, says Dr. Berry Fowler, researcher at Virgina CommonWealth University in Richmond. And the clinical results support it.
via "Doctor Turns Up Possible Treatment For Deadly Sepsis"
Dr. Paul Marik, chief of pulmonary and critical care at Eastern Virginia Medical School, had recently read Fowler's medical journal articles involving the vitamin, and decided to order IV infusions of it, along with hydrocortisone, a steroid, to reduce inflammation. Patients got better, so he advised it to be the new protocol in the ICU. He also added thiamine (Vitamin B). And got a researcher to examine the idea in the lab:
Marik also took the step of having a researcher examine the idea in the lab. He reached out to John Catravas, who studies and teaches on the subject of bioelectrics at Old Dominion University.
Catravas has spent years researching lung function. Of special interest are the lung’s endothelial cells, which form the linings of the blood vessels: “When you have sepsis, the endothelial cells pull away from each other and allow fluid in the lungs.”
He looked at the effect of the Vitamin C, then the steroid, then the two in combination.
It wasn’t one or the other that was doing the trick, but both, almost as though one was holding the door open for the other to do its work in reducing inflammation.
It was a laboratory finding that supported what was happening in the clinical setting, which Marik included in the CHEST publication.
“We can’t both be completely insane,” Marik said.
via "A Norfolk doctor found a treatment for sepsis. Now he's trying to get the ICU world to listen."
Abstract
BackgroundThe global burden of sepsis is estimated as 15 to 19 million cases annually with a mortality rate approaching 60% in low income countries.
MethodsIn this retrospective before-after clinical study, we compared the outcome and clinical course of consecutive septic patients treated with intravenous vitamin C, hydrocortisone and thiamine during a 7-month period (treatment group) compared to a control group treated in our ICU during the preceding 7 months. The primary outcome was hospital survival. A propensity score was generated to adjust the primary outcome.
FindingsThere were 47 patients in both treatment and control groups with no significant differences in baseline characteristics between the two groups. The hospital mortality was 8.5% (4 of 47) in the treatment group compared to 40.4% (19 of 47) in the control group (p < 0.001). The propensity adjusted odds of mortality in the patients treated with the vitamin C protocol was 0.13 (95% CI 0.04-0.48, p=002). The SOFA score decreased in all patients in the treatment group with none developing progressive organ failure. Vasopressors were weaned off all patients in the treatment group, a mean of 18.3 ± 9.8 hours after starting treatment with vitamin C protocol. The mean duration of vasopressor use was 54.9 ± 28.4 hours in the control group (p<0.001).
ConclusionOur results suggest that the early use of intravenous vitamin C, together with corticosteroids and thiamine may prove to be effective in preventing progressive organ dysfunction including acute kidney injury and reducing the mortality of patients with severe sepsis and septic shock. Additional studies are required to confirm these preliminary findings.
Video reviewing the treatment plan, "The Cure For Sepsis": http://www.criticalcarereviews.com/~critic15/index.php/meetings/485-ccr-meetings/ccr-meeting-2017/2896-the-cure-for-sepsis-with-paul-marik
What is Sepsis:
Sepsis is a potentially life-threatening complication of an infection. Sepsis occurs when chemicals released into the bloodstream to fight the infection trigger inflammatory responses throughout the body. This inflammation can trigger a cascade of changes that can damage multiple organ systems, causing them to fail.
If sepsis progresses to septic shock, blood pressure drops dramatically, which may lead to death.
Anyone can develop sepsis, but it's most common and most dangerous in older adults or those with weakened immune systems. Early treatment of sepsis, usually with antibiotics and large amounts of intravenous fluids, improves chances for survival.
(via Mayo Clinic)
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