IV vitamin C signals possible trauma benefit

Clinical takeaway: High-dose IV vitamin C may offer a low-cost adjunctive strategy for trauma patients at risk for sepsis, organ failure, prolonged ICU care, and death. The findings are especially relevant because trauma care has few therapies aimed at the inflammatory, oxidative, and endothelial injury response after resuscitation. Future trials will clarify whether vitamin C helps fill that gap.

High-dose IV vitamin C may improve outcomes in adult trauma patients, but current evidence is not strong enough to support routine clinical use, according to a recent systematic review. The review included six studies involving 5,171 trauma patients admitted to intensive care units, including three randomized controlled trials and three observational studies.

There is a strong biologic rationale for studying vitamin C after major trauma. Severe injury can trigger oxidative stress, endothelial dysfunction, systemic inflammation, tissue damage, and rapid micronutrient depletion. Vitamin C supports antioxidant defense, endothelial function, vasopressor synthesis, collagen formation, and tissue repair, making it a potential adjunct to post-trauma care.

Across the included studies, patients who received high-dose vitamin C had signals of lower mortality, shorter ICU and hospital stays, lower sepsis rates, and less organ failure. Four studies reported lower mortality in vitamin C groups, four reported lower sepsis rates, and two reported lower multi-organ failure or dysfunction.

However, the review does not establish that vitamin C alone improved outcomes. None of the included studies evaluated IV vitamin C monotherapy; vitamin C was given with other agents such as thiamine, vitamin E, N-acetylcysteine, selenium, or zinc. The studies also differed in patient populations, dosing regimens, co-interventions, timing, and outcome reporting, which prevented meta-analysis.

The findings may be especially relevant in military, disaster, or remote trauma settings, where low-cost interventions that are relatively easy to store and administer could be useful.

“Even slight reductions in mortality, sepsis, organ failure or critical care requirement could be used to consider its use in current operational settings, providing a clear rationale for future trauma-specific research before clinical adoption,” the study authors concluded.

Source: Patel NC, et al. 2026 June 30 BMJ Mil Health. A systematic review on the role of high-dose vitamin C in trauma patients