Yazan Zayed, Bashar N Alzghoul, Momen Banifadel, Hima Venigandla, Ryan Hyde, Selina Sutchu, Majd Khasawneh, Zea Borok, Daniel Urbine, Michael Jantz, Raju Reddy
BACKGROUND: There is a conflicting body of evidence regarding the benefit of vitamin C, thiamine, and hydrocortisone in combination as an adjunctive therapy for sepsis with or without septic shock. We aimed to assess the efficacy of this treatment among predefined populations. METHODS: A literature review of major electronic databases was performed to include randomized controlled trials (RCTs) evaluating vitamin C, thiamine, and hydrocortisone in the treatment of patients with sepsis with or without septic shock in comparison to the control group...
March 2022: Journal of Intensive Care Medicine
Ari Moskowitz, David T Huang, Peter C Hou, Jonathan Gong, Pratik B Doshi, Anne V Grossestreuer, Lars W Andersen, Long Ngo, Robert L Sherwin, Katherine M Berg, Maureen Chase, Michael N Cocchi, Jessica B McCannon, Mark Hershey, Ayelet Hilewitz, Maksim Korotun, Lance B Becker, Ronny M Otero, Junior Uduman, Ayan Sen, Michael W Donnino
IMPORTANCE: The combination of ascorbic acid, corticosteroids, and thiamine has been identified as a potential therapy for septic shock. OBJECTIVE: To determine whether the combination of ascorbic acid, corticosteroids, and thiamine attenuates organ injury in patients with septic shock. DESIGN, SETTING, AND PARTICIPANTS: Randomized, blinded, multicenter clinical trial of ascorbic acid, corticosteroids, and thiamine vs placebo for adult patients with septic shock...
August 18, 2020: JAMA
Ping Chang, Yuping Liao, Jianbin Guan, Yuexun Guo, Ming Zhao, Jianmin Hu, Jian Zhou, Hua Wang, Zhongran Cen, Ying Tang, Zhanguo Liu
BACKGROUND: Whether hydrocortisone, vitamin C, and thiamine treatment can reduce the mortality of patients with sepsis is controversial. RESEARCH QUESTION: To evaluate the efficacy and safety of hydrocortisone, vitamin C, and thiamine combination treatment for patients with sepsis or septic shock (HYVCTTSSS). STUDY DESIGN AND METHODS: This single-blind, randomized controlled trial evaluated treatment with hydrocortisone (50 mg every 6 h for 7 days), vitamin C (1...
July 2020: Chest
Jose Iglesias, Andrew V Vassallo, Vishal V Patel, Jesse B Sullivan, Joseph Cavanaugh, Yasmine Elbaga
BACKGROUND: Sepsis is a major public health burden resulting in 25% to 30% in-hospital mortality and accounting for over 20 billion dollars of US hospital costs. RESEARCH QUESTION: Does hydrocortisone, ascorbic acid, thiamine (HAT) therapy improve clinical outcomes in sepsis and septic shock? STUDY DESIGN AND METHODS: This was a randomized, double-blinded, placebo-controlled trial conducted from February 2018 to June 2019, assessing an HAT treatment bundle for the management of septic and septic shock patients admitted to an ICU...
July 2020: Chest
Saleem Javaid Wani, Showkat A Mufti, Rafi A Jan, S U Shah, Syed Mudassir Qadri, Umar Hafiz Khan, Farhana Bagdadi, Nazia Mehfooz, Parvaiz A Koul
Background: Combination of vitamin C, hydrocortisone and thiamine have recently been used in sepsis but data of efficacy are conflicting and no data are available from developing countries. We sought to study the effect of addition of this combination to standard care in patients with sepsis/septic shock in a north Indian setting. Methods: In a prospective, open label, randomised fashion, 100 patients with sepsis/septic shock were recruited to receive either standard therapy alone (control group, n  = 50) or a combination of vitamin C, thiamine and hydrocortisone (treatment group, n  = 50) in addition...
April 2020: Infectious Diseases
Alpha A Fowler, Jonathon D Truwit, R Duncan Hite, Peter E Morris, Christine DeWilde, Anna Priday, Bernard Fisher, Leroy R Thacker, Ramesh Natarajan, Donald F Brophy, Robin Sculthorpe, Rahul Nanchal, Aamer Syed, Jamie Sturgill, Greg S Martin, Jonathan Sevransky, Markos Kashiouris, Stella Hamman, Katherine F Egan, Andrei Hastings, Wendy Spencer, Shawnda Tench, Omar Mehkri, James Bindas, Abhijit Duggal, Jeanette Graf, Stephanie Zellner, Lynda Yanny, Catherine McPolin, Tonya Hollrith, David Kramer, Charles Ojielo, Tessa Damm, Evan Cassity, Aleksandra Wieliczko, Matthew Halquist
IMPORTANCE: Experimental data suggest that intravenous vitamin C may attenuate inflammation and vascular injury associated with sepsis and acute respiratory distress syndrome (ARDS). OBJECTIVE: To determine the effect of intravenous vitamin C infusion on organ failure scores and biological markers of inflammation and vascular injury in patients with sepsis and ARDS. DESIGN, SETTING, AND PARTICIPANTS: The CITRIS-ALI trial was a randomized, double-blind, placebo-controlled, multicenter trial conducted in 7 medical intensive care units in the United States, enrolling patients (N = 167) with sepsis and ARDS present for less than 24 hours...
October 1, 2019: JAMA
Sung Yeon Hwang, Jong Eun Park, Ik Joon Jo, Seonwoo Kim, Sung Phil Chung, Taeyoung Kong, Jonghwan Shin, Hui Jai Lee, Kyoung Min You, You Hwan Jo, Doyun Kim, Gil Joon Suh, Taegyun Kim, Won Young Kim, Youn-Jung Kim, Seung Mok Ryoo, Sung-Hyuk Choi, Tae Gun Shin
BACKGROUND: Septic shock is a life-threatening condition with underlying circulatory and cellular/metabolic abnormalities. Vitamin C and thiamine are potential candidates for adjunctive therapy; they are expected to improve outcomes based on recent experimental and clinical research. The aim of the Ascorbic Acid and Thiamine Effect in Septic Shock (ATESS) trial is to evaluate the effects of early combination therapy with intravenous vitamin C and thiamine on recovery from organ failure in patients with septic shock...
July 11, 2019: Trials
Tomoko Fujii, Andrew A Udy, Adam M Deane, Nora Luethi, Michael Bailey, Glenn M Eastwood, Daniel Frei, Craig French, Neil Orford, Yahya Shehabi, Paul J Young, Rinaldo Bellomo
BACKGROUND: Septic shock is associated with poor outcomes. Vitamin C (ascorbic acid) is a cellular antioxidant and has anti-inflammatory properties. Whether the combination therapy of vitamin C, thiamine and hydrocortisone reduces vasopressor dependency in septic shock is unclear. OBJECTIVES: To describe the protocol and statistical analysis plan of a multicentre, open-label, prospective, phase 2 randomised clinical trial evaluating the effects of vitamin C, thiamine and hydrocortisone when compared with hydrocortisone monotherapy on the duration of vasopressor administration in critically ill patients with septic shock...
June 2019: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
Paul E Marik, Vikramjit Khangoora, Racquel Rivera, Michael H Hooper, John Catravas
BACKGROUND: The global burden of sepsis is estimated as 15 to 19 million cases annually, with a mortality rate approaching 60% in low-income countries. METHODS: In this retrospective before-after clinical study, we compared the outcome and clinical course of consecutive septic patients treated with intravenous vitamin C, hydrocortisone, and thiamine during a 7-month period (treatment group) with a control group treated in our ICU during the preceding 7 months...
June 2017: Chest
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