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Vitamin C sometimes reduces mechanical ventilation duration – meta-analysis Feb 2020

Vitamin C may reduce the duration of mechanical ventilation in critically ill patients: a meta-regression analysis

Journal of Intensive Care volume 8, Article number: 15 (2020) Cite this article
Harri Hemilä & Elizabeth Chalker

VitaminDWiki

This study did not find a difference bewteen oral and IV Vitamin C
It apperas that Extracorporeal Membrane Oxygenation is much better, which was extensively used by the Chinese for COVID-19
ECMO takes blood from a vein, takes out CO2, adds Oxygen, reheats to body temperature, and puts it back in a vein

See Coronavirus and the Potential Role of ECMO Feb 2020 free PDF



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The longer the duration, the more it helps

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Background
Our recent meta-analysis indicated that vitamin C may shorten the length of ICU stay and the duration of mechanical ventilation. Here we analyze modification of the vitamin C effect on ventilation time, by the control group ventilation time (which we used as a proxy for severity of disease in the patients of each trial).

Methods
We searched MEDLINE, Scopus, and the Cochrane Central Register of Controlled Trials and reference lists of relevant publications. We included controlled trials in which the administration of vitamin C was the only difference between the study groups. We did not limit our search to randomized trials and did not require placebo control. We included all doses and all durations of vitamin C administration. One author extracted study characteristics and outcomes from the trial reports and entered the data in a spreadsheet. Both authors checked the data entered against the original reports. We used meta-regression to examine whether the vitamin C effect on ventilation time depends on the duration of ventilation in the control group.

Results
We identified nine potentially eligible trials, eight of which were included in the meta-analysis. We pooled the results of the eight trials, including 685 patients in total, and found that vitamin C shortened the length of mechanical ventilation on average by 14% (P = 0.00001). However, there was significant heterogeneity in the effect of vitamin C between the trials. Heterogeneity was fully explained by the ventilation time in the untreated control group. Vitamin C was most beneficial for patients with the longest ventilation, corresponding to the most severely ill patients. In five trials including 471 patients requiring ventilation for over 10 h, a dosage of 1–6 g/day of vitamin C shortened ventilation time on average by 25% (P < 0.0001).

Conclusions
We found strong evidence that vitamin C shortens the duration of mechanical ventilation, but the magnitude of the effect seems to depend on the duration of ventilation in the untreated control group. The level of baseline illness severity should be considered in further research. Different doses should be compared directly in future trials.

Created by admin. Last Modification: Monday March 16, 2020 11:34:24 GMT-0000 by admin. (Version 8)

Attached files

ID Name Comment Uploaded Size Downloads
13639 Duration.jpg admin 16 Mar, 2020 11:06 47.66 Kb 33
13638 Vit C meta.jpg admin 16 Mar, 2020 11:04 44.99 Kb 20
13637 Vitamin C may reduce the duration of mechanical ventilation in critically ill patients - meta-analysis.pdf PDF 2020 admin 16 Mar, 2020 10:57 1.08 Mb 5
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