Abstract：
In 1747, an important milestone in the history of clinical research was set, as the Scottish surgeon James Lind conducted the first randomized controlled trial. Lind was interested in scurvy, a severe vitamin C deficiency which caused the death of thousands of British seamen. He found that a dietary intervention with oranges and lemons, which are rich in vitamin C by nature, was effective to recover from scurvy. Because of its antioxidative properties and involvement in many biochemical processes, the essential micronutrient vitamin C plays a key role in the human biology. Moreover, the use of vitamin C in critical illness-a condition also resulting in death of thousands in the 21st century-has gained increasing interest, as it may restore vascular responsiveness to vasoactive agents, ameliorate microcirculatory blood flow, preserve endothelial barriers, augment bacterial defense, and prevent apoptosis. Because of its redox potential and powerful antioxidant capacity, vitamin C represents an inexpensive and safe antioxidant, with the potential to modify the inflammatory cascade and improve clinical outcomes of critically ill patients. This narrative review aims to update and provide an overview on the role of vitamin C in the human biology and in critically ill patients, and to summarize current evidence on the use of vitamin C in diverse populations of critically ill patients, in specific focusing on patients with sepsis and coronavirus disease 2019.
摘要：
1747年，建立了临床研究历史上的一个重要里程碑，苏格兰外科医生JamesLind进行了第一项随机对照试验。林德对镰刀病感兴趣,严重的维生素C缺乏症导致数千名英国海员死亡。他发现用橘子和柠檬进行饮食干预，含有丰富的维生素C，能有效地从镰刀症中恢复过来.由于其抗氧化特性和参与许多生化过程，必需的微量营养素维生素C在人类生物学中起着关键作用。此外，维生素C在危重病中的使用-这种疾病在21世纪也导致数千人死亡-引起了越来越多的兴趣，因为它可以恢复血管对血管活性剂的反应，改善微循环血流量，保护内皮屏障，增强细菌防御，并防止细胞凋亡。由于其氧化还原电位和强大的抗氧化能力，维生素C是一种廉价且安全的抗氧化剂，有可能改变炎症级联反应并改善危重患者的临床结局。这篇叙述性综述旨在更新和概述维生素C在人类生物学和危重病人中的作用。并总结目前在不同危重患者人群中使用维生素C的证据，2019年重点关注脓毒症和冠状病毒病患者。
