Sachit Sharma, Hem R Paneru, Gentle S Shrestha, Pramesh S Shrestha, Subhash P Acharya
{"title":"评价维生素C、硫胺素和氢化可的松联合应用与单用氢化可的松对感染性休克患者ICU预后的影响：一项随机对照试验。","authors":"Sachit Sharma, Hem R Paneru, Gentle S Shrestha, Pramesh S Shrestha, Subhash P Acharya","doi":"10.5005/jp-journals-10071-24852","DOIUrl":null,"url":null,"abstract":"<p><strong>Aims and background: </strong>Glucocorticoids, vitamin C and thiamine have important biological effects in patients with sepsis and septic shock. Multiple studies have demonstrated the beneficial role of a combination therapy of vitamin C, hydrocortisone and thiamine in patients with sepsis and septic shock in terms of mortality reduction, and increase in the number of days free of ventilators and vasopressors.</p><p><strong>Materials and methods: </strong>Patients who had septic shock were assessed for eligibility after intensive care unit (ICU) admission. After randomization, the treatment group received a combination of vitamin C, thiamine and hydrocortisone for a duration of 96 hours (16 doses) and the control group received hydrocortisone for a duration till the patient was on vasopressors. The primary outcome assessed was ICU mortality, and the key secondary outcome was the duration free of vasopressor administration at the end of 7 days.</p><p><strong>Results: </strong>A total of 86 patients were included in the study. Seventy percent of patients in the control group and 58 percent in the intervention group died during ICU stay. None of the primary and secondary outcomes were statistically significant.</p><p><strong>Conclusion: </strong>The use of a combination of vitamin C, hydrocortisone and thiamine has no added benefits over the use of hydrocortisone alone in patients with septic shock.</p><p><strong>Clinical significance: </strong>The results of this clinical trial shows that the use of a combination of vitamin C, hydrocortisone and thiamine in patients with septic shock is not useful and should not be a routine practice in critically ill septic patients.</p><p><strong>How to cite this article: </strong>Sharma S, Paneru HR, Shrestha GS, Shrestha PS, Acharya SP. Evaluation of the Effects of a Combination of Vitamin C, Thiamine and Hydrocortisone vs Hydrocortisone Alone on ICU Outcome in Patients with Septic Shock: A Randomized Controlled Trial. Indian J Crit Care Med 2024;28(12):1147-1152.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"28 12","pages":"1147-1152"},"PeriodicalIF":1.5000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695884/pdf/","citationCount":"0","resultStr":"{\"title\":\"Evaluation of the Effects of a Combination of Vitamin C, Thiamine and Hydrocortisone vs Hydrocortisone Alone on ICU Outcome in Patients with Septic Shock: A Randomized Controlled Trial.\",\"authors\":\"Sachit Sharma, Hem R Paneru, Gentle S Shrestha, Pramesh S Shrestha, Subhash P Acharya\",\"doi\":\"10.5005/jp-journals-10071-24852\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aims and background: </strong>Glucocorticoids, vitamin C and thiamine have important biological effects in patients with sepsis and septic shock. Multiple studies have demonstrated the beneficial role of a combination therapy of vitamin C, hydrocortisone and thiamine in patients with sepsis and septic shock in terms of mortality reduction, and increase in the number of days free of ventilators and vasopressors.</p><p><strong>Materials and methods: </strong>Patients who had septic shock were assessed for eligibility after intensive care unit (ICU) admission. After randomization, the treatment group received a combination of vitamin C, thiamine and hydrocortisone for a duration of 96 hours (16 doses) and the control group received hydrocortisone for a duration till the patient was on vasopressors. The primary outcome assessed was ICU mortality, and the key secondary outcome was the duration free of vasopressor administration at the end of 7 days.</p><p><strong>Results: </strong>A total of 86 patients were included in the study. Seventy percent of patients in the control group and 58 percent in the intervention group died during ICU stay. None of the primary and secondary outcomes were statistically significant.</p><p><strong>Conclusion: </strong>The use of a combination of vitamin C, hydrocortisone and thiamine has no added benefits over the use of hydrocortisone alone in patients with septic shock.</p><p><strong>Clinical significance: </strong>The results of this clinical trial shows that the use of a combination of vitamin C, hydrocortisone and thiamine in patients with septic shock is not useful and should not be a routine practice in critically ill septic patients.</p><p><strong>How to cite this article: </strong>Sharma S, Paneru HR, Shrestha GS, Shrestha PS, Acharya SP. Evaluation of the Effects of a Combination of Vitamin C, Thiamine and Hydrocortisone vs Hydrocortisone Alone on ICU Outcome in Patients with Septic Shock: A Randomized Controlled Trial. 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Evaluation of the Effects of a Combination of Vitamin C, Thiamine and Hydrocortisone vs Hydrocortisone Alone on ICU Outcome in Patients with Septic Shock: A Randomized Controlled Trial.
Aims and background: Glucocorticoids, vitamin C and thiamine have important biological effects in patients with sepsis and septic shock. Multiple studies have demonstrated the beneficial role of a combination therapy of vitamin C, hydrocortisone and thiamine in patients with sepsis and septic shock in terms of mortality reduction, and increase in the number of days free of ventilators and vasopressors.
Materials and methods: Patients who had septic shock were assessed for eligibility after intensive care unit (ICU) admission. After randomization, the treatment group received a combination of vitamin C, thiamine and hydrocortisone for a duration of 96 hours (16 doses) and the control group received hydrocortisone for a duration till the patient was on vasopressors. The primary outcome assessed was ICU mortality, and the key secondary outcome was the duration free of vasopressor administration at the end of 7 days.
Results: A total of 86 patients were included in the study. Seventy percent of patients in the control group and 58 percent in the intervention group died during ICU stay. None of the primary and secondary outcomes were statistically significant.
Conclusion: The use of a combination of vitamin C, hydrocortisone and thiamine has no added benefits over the use of hydrocortisone alone in patients with septic shock.
Clinical significance: The results of this clinical trial shows that the use of a combination of vitamin C, hydrocortisone and thiamine in patients with septic shock is not useful and should not be a routine practice in critically ill septic patients.
How to cite this article: Sharma S, Paneru HR, Shrestha GS, Shrestha PS, Acharya SP. Evaluation of the Effects of a Combination of Vitamin C, Thiamine and Hydrocortisone vs Hydrocortisone Alone on ICU Outcome in Patients with Septic Shock: A Randomized Controlled Trial. Indian J Crit Care Med 2024;28(12):1147-1152.
期刊介绍：
Indian Journal of Critical Care Medicine (ISSN 0972-5229) is specialty periodical published under the auspices of Indian Society of Critical Care Medicine. Journal encourages research, education and dissemination of knowledge in the fields of critical and emergency medicine.
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