How Intravenous Vitamin C May Be Lifesaving in Acute Sepsis! – An Interview with Ramesh Natarajan, PhD

How Intravenous Vitamin C May Be Lifesaving in Acute Sepsis! (25:29)
Kirk’s video overview of his interview with Dr. Natarajan (2:49)
Sepsis is a massive acute “autoimmune response” from an infection in which the immune system attacks one’s internal organs, resulting in their failure and death from vascular collapse. Low plasma vitamin C levels increase the risk to sepsis. 41% percent of hospitalized patients are deficient in vitamin C and 19% have scurvy (classic vitamin C deficiency).

Sepsis costs 20 billion dollars a year in the U.S. to treat. A day treatment in the hospital can cost $18,000-20,000. A single dose of intravenous vitamin C may cost $50.00.

Vitamin C may work in reducing sepsis incidence and prevent death by:

  • Vitamin C is required for normal endothelial function.
  • Vitamin C can reduce endothelial permeability in sepsis.
  • Vitamin C reduces leukocyte plugging of microvessels.
  • Critical pro-inflammatory proteins are attenuated by vitamin C .
  • Vitamin C stabilizes immune function in sepsis.
  • Vitamin C may relieve hypotension associated with sepsis.
  • Vitamin C preserves lung barrier function and improves alveolar fluid clearance in sepsis.
  • Vitamin C normalized the coagulopathy of sepsis.
  • Vitamin C is anti-infective and has profound bacteriostatic effects.

SUMMARY:  In septic patients intravenous vitamin C at 50 mg/kg/day or 200 mg/kg/day or placebo in 4 divided doses administered over 30 minutes every 6 hours for 96 hours in 50 ml of 5% dextrose and water achieved plasma levels of 300µM and 3mM of vitamin C respectively and exhibited rapid reductions in multiple organ injury (SOFA) scores while no such reduction was seen in placebo patients. Ascorbic acid significantly reduced the pro-inflammatory biomarkers C-reactive protein and procalcitonin indicating a reduction in systemic inflammation. Unlike placebo patients, thrombomodulin in ascorbic acid infused patients exhibited no significant rise. Thrombomodulin is a protein normally bound to the surface of endothelial cells and not found free in the circulation. If the blood level of thrombomodulin rises, it is indicative of vascular injury. These results suggest attenuation of vascular endothelial injury with intravenous vitamin C. There were no side effects noted from the intravenous vitamin C. Accurate methods of accessing vitamin C in the critical care setting are with HPLC analysis and the fluorescent end-point assay. Ascorbate-dependent vasopressor synthesis: a rationale for vitamin C administration in severe sepsis and septic shock?Crit Care. 2015 Nov 27;19:418. 51301 (5/2016) Ramesh Natarajan, Ph.D. Division of Pulmonary Disease and Critical Care Medicine Department of Internal Medicine, School of Medicine Virginia Commonwealth University Box 980050, Richmond, VA, 23298, USA ramesh.natarajan@vcuhealth.org

Expert Interview by Kirk Hamilton PA-C with Alpha A. Fowler, III, MD Sepsis in the Hospital and High Dose Intravenous Ascorbic Acid

“Intravenous Vitamin C – Integrative Therapies” a first-time conference sponsored by the University of Kansas Medical Center, September 30 – October 1, 2016. (See Dr. Drisko interview). Dr. Ramesh Natarajan will be speaking at this conference.

Be and Stay Well,

Kirk

You may call Kirk Hamilton PA-C Monday thru Friday 8-9 a.m. PST at 916-489-4400 for brief medical questions at Health Associates Medical Group. (for information about Health Associates go to KwikerMedical.com)

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