Saturday, April 8, 2017

A “Cure” for Severe Sepsis and Septic Shock?

R.E.B.E.L.EM - April 7, 2017 - Expert Peer Review Haney Mallemat
Background: The overall mortality in sepsis has decreased quite a bit in the last decade or so, however for a subset of patients, like those with Septic Shock, the mortality still remains high (as high as 50%). There have been hundreds of studies trying to identify the holy grail to decrease mortality further, but one has not been found thus far. Marik PE et al published a study in Chest 2016 that has found a potential front runner. In addition, the authors go on to say, in order to have an impact on a global scale, treatments would not only need to be effective, but also cheap, safe, and readily available; the authors of the following paper may have found just that..
Author Conclusion: “Our results suggest that 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.”
Clinical Take Home Point: Although the results of this study are very promising, it is important to remember that this was only a hypothesis generating study. We still need an external validation before implementation (How many other treatments in sepsis have been touted as a “cure” and not panned out in subsequent studies?).