While the use of vitamin C as a therapeutic agent has been investigated since the 1950s, there has been substantial recent interest in the role of vitamin C supplementation in critical illness and particularly, sepsis and septic shock. Humans cannot synthesize vitamin C and rely on exogenous intake to maintain a plasma concentration of approximately 70 to 80 μmol/L. Vitamin C, in healthy humans, is involved with antioxidant function, wound healing, endothelial function, and catecholamine synthesis. Its function in the human body informs the theoretical basis for why vitamin C supplementation may be beneficial in sepsis/septic shock.

Critically ill patients can be vitamin C deficient due to low dietary intake, increased metabolic demands, inefficient recycling of vitamin C metabolites, and loss due to renal replacement therapy. Intravenous supplementation is required to achieve supraphysiologic serum levels of vitamin C. While some clinical studies of intravenous vitamin C supplementation in sepsis have shown improvements in secondary outcome measures, none of the randomized clinical trials have shown differences between vitamin C supplementation and standard of care and/or placebo in the primary outcome measures of the trials. There are some ongoing studies of high-dose vitamin C administration in patients with sepsis and coronavirus disease 2019; the majority of evidence so far does not support the routine supplementation of vitamin C in patients with sepsis or septic shock.

虽然自 1950 年代以来一直在研究使用维生素 C 作为治疗剂，但最近人们对补充维生素 C 在危重疾病，特别是败血症和感染性休克中的作用产生了浓厚的兴趣。人类不能合成维生素C，只能靠外源性摄入来维持血浆浓度在70～80μmol/L左右。在健康人类中，维生素 C 与抗氧化功能、伤口愈合、内皮功能和儿茶酚胺合成有关。它在人体中的作用为为什么补充维生素 C 可能有益于败血症/感染性休克提供了理论基础。

危重病患者可能由于饮食摄入量低、代谢需求增加、维生素 C 代谢物回收效率低下以及肾脏替代治疗导致维生素 C 缺乏而缺乏维生素 C。需要静脉补充以达到维生素 C 的超生理血清水平。虽然一些脓毒症静脉补充维生素 C 的临床研究显示次要结果指标有所改善，但没有一项随机临床试验显示维生素 C 补充与护理标准之间存在差异/或安慰剂在试验的主要结果测量中。目前正在进行一些关于在 2019 年败血症和冠状病毒病患者中服用高剂量维生素 C 的研究；迄今为止，大多数证据不支持败血症或感染性休克患者常规补充维生素 C。