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Vitamin C for #sepsis
Marik et al: Retrospective before–after study (2017): n 47
Hydrocortisone, Vit C & thiamine vs controls:
* Hosp mortality: 8.5% vs 40.4%
* SOFA decreased with none in Vit C group developing organ failure
How has data panned out since?
#CHESTCritCare
Marik et al: Retrospective before–after study (2017): n 47
Hydrocortisone, Vit C & thiamine vs controls:
* Hosp mortality: 8.5% vs 40.4%
* SOFA decreased with none in Vit C group developing organ failure
How has data panned out since?
#CHESTCritCare
CITRIS-ALI RCT @JAMANetwork 2019:
In sepsis + ARDS, IV Vit C (n 84) vs placebo (n 83):
No difference in mod SOFA at 96 hours or CRP/thrombomodulin levels at 168 hours.
#CHESTCritCare
In sepsis + ARDS, IV Vit C (n 84) vs placebo (n 83):
No difference in mod SOFA at 96 hours or CRP/thrombomodulin levels at 168 hours.
#CHESTCritCare
VITAMINS RCT @JAMANetwork 2020:
IV Vit C, hydrocortisone & thiamine (n 109) vs hydrocortisone (n 107) alone in #Sepsis
No difference in primary outcome: duration of time alive AND free of vasopressor administration over 7 days (122.1 hours vs 124.6 hours)
#CHESTCritCare
IV Vit C, hydrocortisone & thiamine (n 109) vs hydrocortisone (n 107) alone in #Sepsis
No difference in primary outcome: duration of time alive AND free of vasopressor administration over 7 days (122.1 hours vs 124.6 hours)
#CHESTCritCare
HYVCTTSSS RCT in #journalCHEST 2020
https://pubmed.ncbi.nlm.nih.gov/32243943/
IV Vit C, hydrocortisone & thiamine vs placebo in #Sepsis (n 40 each)
No difference in 28-day all-cause mortality was observed (27.5% vs 35%)
#CHESTCritCare
https://pubmed.ncbi.nlm.nih.gov/32243943/
IV Vit C, hydrocortisone & thiamine vs placebo in #Sepsis (n 40 each)
No difference in 28-day all-cause mortality was observed (27.5% vs 35%)
#CHESTCritCare
ORANGES RCT in #journalCHEST 2020:
Vit C, hydrocortisone & thiamine (n 68) vs control (n 69) in #Sepsis and Septic shock
* Quicker reversal of shock in Rx group (27 +/-
22 vs 53 +/- 38 hours, P < .001)
* No diff in SOFA score, ICU/hospital mortality/LOS, ventilator free days
Vit C, hydrocortisone & thiamine (n 68) vs control (n 69) in #Sepsis and Septic shock
* Quicker reversal of shock in Rx group (27 +/-
22 vs 53 +/- 38 hours, P < .001)
* No diff in SOFA score, ICU/hospital mortality/LOS, ventilator free days
ACTS RCT @JAMANetwork 2020:
Vit C, hydrocortisone & thiamine Q 6 hours (n 103) vs placebo (n 102) x 4 days in matching volumes at the same time points.
No statistically significant reduction in SOFA score during the first 72 hours after enrollment.
Note the adverse effects:
Vit C, hydrocortisone & thiamine Q 6 hours (n 103) vs placebo (n 102) x 4 days in matching volumes at the same time points.
No statistically significant reduction in SOFA score during the first 72 hours after enrollment.
Note the adverse effects:
ATESS RCT (ICM 2020):
Vit C & thiamine (n 53) vs placebo (n 58) in #SepticShock:
No significant difference in ΔSOFA scores after 72 hours.
#CHESTCritCare
Vit C & thiamine (n 53) vs placebo (n 58) in #SepticShock:
No significant difference in ΔSOFA scores after 72 hours.
#CHESTCritCare
Take a look at this informative thread by @nickmmark summarizing this data as well:
https://twitter.com/nickmmark/status/1295857244098027521?s=20
TL;DR: ORANGES are not the new ANTIBIOTICS.
Let us know your thoughts!
https://twitter.com/nickmmark/status/1295857244098027521?s=20
TL;DR: ORANGES are not the new ANTIBIOTICS.
Let us know your thoughts!
