Promising results from an initial clinical trial show that sodium ascorbate – a pH-balanced formulation of vitamin C – is effective in treating sepsis.
I think this is important context that you don’t see in that press release (and which is why I would advise the community to favor posting studies more than news reports):
“Our findings appear to differ from those of recent randomized controlled trials, which assessed the effect of very high dose vitamin C in patients with sepsis.”
This is one 30-person trial in a sea of trials that have been pretty equivocal so far regarding high dose vitamin C in sepsis.
Also, as a critical care nurse, I’d probably be inclined to advise against using 24 hour urine output as a primary endpoint. Not that I’m saying we’re not perfect! (Lol) But there are those days when everything is so busy that the exact urine count isn’t the highest priority. Sometimes the urine output number sits in the back of your head with a binary “enough” or “not enough” tag and you might miss putting one of the times you emptied the urine bag into the computer.
I don’t love that, but the state of hospital staffing and having extremely ill human beings trying real hard to die on you sometimes forces you to prioritize things that are all important. And of the important things, as long as urine output exceeds the “enough” threshold, it’s not the most important important thing.
Not every day will be so swamped that it forces that kind of compromise, so the numbers will average out over the course of a few days, which appears to be reflected in this study.
This is a good point, and it is something that is covered under our new rules, but it hasn’t been enforced that well since there isn’t as much content.
We really appreciate comments like yours and encourage everyone to add links and quotes from the study/paper when possible. Also if you think something does not belong, please do report it and we’ll take a look :)
I actually just found the community tonight. Glad to see you here! Thanks for starting this!
(Sometimes I like to state the obvious out loud in comments because I know people don’t read the rules lol. I find it’s how development of a self-reinforcing community culture occurs organically. That was my experience with more niche communities on that other site anyway.)
Thank you for pointing this out. Saw the headline and was like, not this vitamin c crap again. So many trials have failed for this, critical care just seems obsessed with the idea and will not give it up. I agree their end points are very unconvincing. The group treated in addition to increased urine output had some kind of induced hypernatremia. Would need more info to be sure, but all this says to me is they probably caused some sort of mild diuretic effect.
I think it’s just an effect of giving them sodium ascorbate instead of ascorbic acid. It’s not the usual cause of hypernatremia, but it is possible to cause hypernatremia with that high a level of sodium intake, especially in the setting of kidney failure. I think they knew that and that’s why they specifically noted that side effect.
I think this is important context that you don’t see in that press release (and which is why I would advise the community to favor posting studies more than news reports):
“Our findings appear to differ from those of recent randomized controlled trials, which assessed the effect of very high dose vitamin C in patients with sepsis.”
This is one 30-person trial in a sea of trials that have been pretty equivocal so far regarding high dose vitamin C in sepsis.
Also, as a critical care nurse, I’d probably be inclined to advise against using 24 hour urine output as a primary endpoint. Not that I’m saying we’re not perfect! (Lol) But there are those days when everything is so busy that the exact urine count isn’t the highest priority. Sometimes the urine output number sits in the back of your head with a binary “enough” or “not enough” tag and you might miss putting one of the times you emptied the urine bag into the computer.
I don’t love that, but the state of hospital staffing and having extremely ill human beings trying real hard to die on you sometimes forces you to prioritize things that are all important. And of the important things, as long as urine output exceeds the “enough” threshold, it’s not the most important important thing.
Not every day will be so swamped that it forces that kind of compromise, so the numbers will average out over the course of a few days, which appears to be reflected in this study.
The actual study, for reference: https://ccforum.biomedcentral.com/articles/10.1186/s13054-023-04644-x
This is a good point, and it is something that is covered under our new rules, but it hasn’t been enforced that well since there isn’t as much content.
We really appreciate comments like yours and encourage everyone to add links and quotes from the study/paper when possible. Also if you think something does not belong, please do report it and we’ll take a look :)
I actually just found the community tonight. Glad to see you here! Thanks for starting this!
(Sometimes I like to state the obvious out loud in comments because I know people don’t read the rules lol. I find it’s how development of a self-reinforcing community culture occurs organically. That was my experience with more niche communities on that other site anyway.)
For sure, it definitely helps :)
Thank you for pointing this out. Saw the headline and was like, not this vitamin c crap again. So many trials have failed for this, critical care just seems obsessed with the idea and will not give it up. I agree their end points are very unconvincing. The group treated in addition to increased urine output had some kind of induced hypernatremia. Would need more info to be sure, but all this says to me is they probably caused some sort of mild diuretic effect.
I think it’s just an effect of giving them sodium ascorbate instead of ascorbic acid. It’s not the usual cause of hypernatremia, but it is possible to cause hypernatremia with that high a level of sodium intake, especially in the setting of kidney failure. I think they knew that and that’s why they specifically noted that side effect.