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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com




Friday, February 3, 2017

Hydrocortisone, Vit C and Thiamine for Sepsis

The Bottom line - February 3, 2017 - By Steve Mathieu
Ref: Marik. CHEST 2016; published on line first Dec 2016 doi:10.1016/j.chest.2016.11.036
"Clinical Question
Does intravenous vitamin C, hydrocortisone and thiamine in addition to standard treatment, improve mortality in ICU patients with severe sepsis or septic shock, compared with standard treatment alone?...
Authors’ Conclusions
The early use of intravenous vitamin C, together with corticosteroids and thiamine may prove to be effective in preventing progressive organ dysfunction including acute kidney injury and reducing the mortality of patients with severe sepsis and septic shock. Additional studies are required to confirm these preliminary findings
The Bottom Line
This study is hypothesis generating. An RCT is required to determine the efficacy of vitamin C, steroids and thiamine in severe sepsis and septic shock. The results of ADRENAL will help guide future use of corticosteroids. I will not consider using vitamin C or thiamine in sepsis until additional studies, demonstrating benefit, are completed. Until then, I will eagerly wait to see if the combination of vitamin C, steroids and thiamine offers a ‘Marikle’ cure for sepsis"