Table 1.
Study characteristics
| Author | Inclusion criteria | Exclusion criteria | Age |
|---|---|---|---|
| Fujii | Septic shock based on Sepsis-3 consensus | Age < 18 years, do-not-resuscitate, imminent death, diagnosis of septic shock > 24 h; Contraindication/other indication for study drug | 61.7 ± 15 |
| Park | Diagnosed with septic shock during ED stay and admitted to the ICU | Age < 18 years, do-not-resuscitate |
I: 69 (IQR: 60–76) C: 69 (IQR: 61–76) |
| Iglesias | Diagnosis of sepsis/septic shock within 12 h of admission to ICU | Age < 18 years, do-not-resuscitate or intubate, pregnant, terminal disease (e.g., stage IV cancer, end-stage heart failure), no primary diagnosis of sepsis or septic shock, immediate surgery required, HIV + CD4 < 50 mm2, glucose-6 phosphate dehydrogenase deficiency, transferred from another hospital, presented with sepsis or septic shock > 24 h from admission |
I: 70 ± 12 C: 67 ± 14 |
| Fowler III 2014 | Diagnosis of septic shock within 48 h of admission to ICU + informed consent | NA |
I: low Vit C: 30–70 I: high Vit C: 49–92 C: 54–68 |
| Fowler III 2019 | ICU admission for sepsis + acute respiratory failure, mechanical ventilation through an endotracheal tube, PaO2 to FiO2 ratio less than 300 mm Hg, bilateral opacities, new or worsening respiratory symptoms without evidence of left atrial hypertension, suspected or proven infection, and met two of four systemic inflammatory response criteria. All criteria had to be met within 24 h | Age < 18 years; allergy to vitamin C; no informed consent; more than 48 h elapsed meeting ARDS criteria; they did not have a patient surrogate or physician committed to full support; pregnant or breastfeeding; moribund and not expected to survive 24 h; required home mechanical ventilation (via tracheostomy or noninvasively); receiving home oxygen > 2 L/min; had interstitial lung disease, diffuse alveolar hemorrhage, diabetic ketoacidosis, active kidney stone |
I: 54 (IQR: 39–67) C: 57 (IQR: 44–70) |
| Marik | Diagnosis of severe sepsis or septic shock + procalcitonin ≥ 2 ng/mL were treated with intravenous hydrocortisone, vitamin C, and thiamine | Age < 18 years, pregnant, septic patients with a PCT level < 2 ng/mL within the first 24 h of ICU admission were not treated with the vitamin C protocol |
I: 58.3 ± 14.1 C: 62.2 ± 14.3 |
| Nabil Habib | Septic shock based on Sepsis-3 consensus + at least one positive blood culture | Age < 18 years, pregnant/lactating; History of oxalate nephrolithiasis, known glucose-6 phosphate dehydrogenase deficiency, paroxysmal nocturnal hemoglobinuria, hereditary hemochromatosis, any other type of shock state or patients with mixed type of shock |
I: 42.78 ± 9.49 C: 41.70 ± 10.2 |
| Wani | Sepsis and septic shock, Sepsis-3 consensus | Age < 18 years, pregnant |
I: 65 (IQR: 25–72) C: 70 (IQR: 25–72) |
| Litwak | International Classification of Disease (ICD)-10 code for “septic shock” + Vasopressors + adult patients | Pregnant |
I: 58.3 ± 17.0 C: 60.1 ± 14.0 |
| Chang | Sepsis and septic shock, Sepsis-3 consensus | Age < 18 years, pregnant, non-septic shock, therapy limitation |
I: 59.5 ± 15.0 C: 63.7 ± 12.8 |
| Mitchell | Sepsis or septic shock defined by the 2012/2016 Surviving Sepsis Guidelines. Patients admitted to ICU who received vitamin C, Thiamine, and Hydrocortisone | NA |
I: 68 ± 10 C: 68 ± 10 |
| Ahn | Sepsis and septic shock | Age < 18 years, pregnant, death within 24 h from ICU admission, do-not-resuscitate or intubate, and organ transplantation during ICU stay |
I: 67.8 ± 12.1 C: 63.6 ± 15.3 |
| Sadaka | Sepsis and septic shock, Sepsis-3 consensus | Age < 18 years |
I: 67 ± 16 C: 70 ± 12 |
| Zabet | Sepsis and septic shock | Age < 18 years, use of other antioxidants (e.g., vitamin E, selenium, N-acetylcysteine), corticosteroids, known glucose-6 phosphate dehydrogenase deficiency, and contraindication for high-dose vitamin C |
I: 64.14 ± 15.98 C: 63.71 ± 13.84 |
| Shin | Septic shock diagnosed in an ED | Age < 18 years, do-not-resuscitate order; septic shock recognized > 6 h after arrival in the ED; transferred from other hospitals/did not meet the inclusion criteria on ED arrival |
I: 67 (58–76) C: 67 (60–75) |
| Hwang | Septic shock diagnosed in an ED, defined as sepsis with persisting hypotension, lactate levels > 2 mmol/L despite adequate fluid challenge | Age < 19 years |
I: 70 (62–76) C: 69 (62–74) |
| Moskowitz | Sepsis and suspected/confirmed infection + vasopressors | Age < 18 years, allergic to any study drugs, kidney stones within the last year, glucose-6 phosphate dehydrogenase deficiency or hemochromatosis, kidney replacement therapy, not expected to survive 24 h |
I: 68.9 ± 15 C: 67.7 ± 13.9 |
HIV human immunodeficiency virus, ICU intensive care unit, NA not available, ED emergency department