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




Sunday, August 23, 2020

Vitamin C, Corticosteroids an Thiamine in Sepsis

St. Emlyn´s - By Carley S -  August 23, 2020
..."This paper once again finds little evidence and no real signal for the effectiveness of thiamine, steroids and vitamin C in sepsis patients when tested in a placebo controlled randomised controlled trial. However, there will be those who will question whether this is what Marik originally suggested. Notably the intervention/randomisation took place some time after the patients were identified, although this was tested and there did not seem to be any time effect (although the numbers get quite small for early interventions).
Similarly many patients were excluded because they were already on steroids, one of the reasons for the small number recruited as compared to those screened (following trials like ADRENAL), so perhaps the intervention should have been the three drugs vs. mineralocorticoids. Having said that we might still have expected to see some signal here and there is none.
The bottom line.
Evidence for the effectiveness of vitamin C, thiamine and steroids in combination remains elusive and cannot be routinely recommended.