You are here

Responses

Article menu
Download PDFPDF
Best evidence topic reports
Bet 2: Does intravenous vitamin C improve mortality in patients with severe sepsis?
Compose a Response to This Article
Compose Response

More information about text formats

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Author Information
First or given name, e.g. 'Peter'.
Your last, or family, name, e.g. 'MacMoody'.
Your email address, e.g. higgs-boson@gmail.com
Your role and/or occupation, e.g. 'Orthopedic Surgeon'.
Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.
Statement of Competing Interests

PLEASE NOTE:

  • A rapid response is a moderated but not peer reviewed online response to a published article in a BMJ journal; it will not receive a DOI and will not be indexed unless it is also republished as a Letter, Correspondence or as other content. Find out more about rapid responses.
  • We intend to post all responses which are approved by the Editor, within 14 days (BMJ Journals) or 24 hours (The BMJ), however timeframes cannot be guaranteed. Responses must comply with our requirements and should contribute substantially to the topic, but it is at our absolute discretion whether we publish a response, and we reserve the right to edit or remove responses before and after publication and also republish some or all in other BMJ publications, including third party local editions in other countries and languages
  • Our requirements are stated in our rapid response terms and conditions and must be read. These include ensuring that: i) you do not include any illustrative content including tables and graphs, ii) you do not include any information that includes specifics about any patients,iii) you do not include any original data, unless it has already been published in a peer reviewed journal and you have included a reference, iv) your response is lawful, not defamatory, original and accurate, v) you declare any competing interests, vi) you understand that your name and other personal details set out in our rapid response terms and conditions will be published with any responses we publish and vii) you understand that once a response is published, we may continue to publish your response and/or edit or remove it in the future.
  • By submitting this rapid response you are agreeing to our terms and conditions for rapid responses and understand that your personal data will be processed in accordance with those terms and our privacy notice.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

Vertical Tabs

Other responses

Jump to comment:

  • Published on: 28 March 2018
    Vitamin C may shorten ICU stay

    The paper by Sheikh and Horner [1] does not properly describe the context for vitamin C.

    Fourteen trials have investigated the effect of vitamin C against post-operative AF (POAF), and significant heterogeneity has appeared between studies carried out in the USA and outside of the USA [2]. In 9 non-US studies vitamin C decreased the incidence of POAF on average by 46% (P<0.00001), but no benefit was seen in 5 US studies.

    In 5 non-US studies, intravenous vitamin C shortened the duration of hospital stay on average by 16% and by 1.47 days (P<0.00001). In 7 non-US studies, oral and intravenous vitamin C shortened the duration of ICU stay on average by 7% (P=0.002)[2]. Thus, there is strong evidence from randomized trials indicating that vitamin C may influence the duration of hospital stay and ICU stay in some contexts. It is not reasonable to restrict to mortality as the only outcome of interest [1], when considering potential effects of vitamin C on ICU patients.

    Sheikh and Horner do not mention that sometimes vitamin C levels are very low in hospital patients. For example, in one study 18 patients with clinical symptoms of scurvy were identified out of 145 consecutive patients [3]. Scurvy has been reported also in modern ICUs [4].

    In their clinical scenario, Sheikh and Horner described a patient with pneumonia, but ignored the association between vitamin C and pneumonia. Vitamin C deficiency increases the risk of pneumonia, and pneumonia d...

    Show More
    Conflict of Interest:
    None declared.