Ascorbic Acid, Thiamine, and Steroids in Septic Shock: Propensity Matched Analysis. (November 2020)

• Record Type: Journal Article
• Authors: Sadaka, Farid; Grady, Justin; Organti, Nikhil; Donepudi, Bhargavi; Korobey, Matthew; Tannehill, David; O'Brien, Jacklyn
• Is Part Of: Journal of intensive care medicine. Volume 35:Number 11(2020)
• Page Start: 1302
• Page End: 1306
• Publication Date: 2020-11
• Subjects: sepsis -- septic shock -- ascorbic acid -- vitamin C -- thiamine -- steroids -- outcome -- mortality; Critical care medicine -- Periodicals; Critical Care -- Periodicals; Soins intensifs -- Périodiques; Soins intensifs; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); 616.02805
• DOI: 10.1177/0885066619864541
• Languages: English
• ISSNs: 0885-0666

Abstract

Introduction: We aimed to study the use of ascorbic acid, thiamine, and steroids (ATS) in patients with septic shock (SS). Methods: Data on 62 patients with SS were collected from Acute Physiologic and Chronic Health Evaluation (APACHE) Outcome database and medical records. The ATS group received full doses of intravenous (IV) ATS (ascorbic acid [1.5 g every 6 hours for 4 days], hydrocortisone [50 mg every 6 hours for 7 days], and thiamine [200 mg every 12 hours for 4 days]). Data included age, gender, APACHE III, acute physiologic score (APS), mechanical ventilation (MV), lactic acid (LA), serum creatinine (Cr), duration of vasopressors (VP, days, median: interquartile ranges [IQR]: [Q1, Q3]), MV-free days (median: IQR [Q1-Q3]), percentage of patients requiring renal replacement therapy (RRT) for acute kidney injury (AKI), and mortality. Propensity analysis was used to match patients on age, gender, MV, APACHE III, APS, LA, and Cr. Results: The ATS group had longer duration of VP (4.5: 4.0-6.0 vs 2.0: 1.0-2.0, P = .001), similar RRT for AKI (26% vs 29%, P = .8), similar MV-free days (10.2: 5.0-15.0 vs 10.2: 1.6-18.0, P > .9), lower intensive care unit mortality (9.6% vs 42%, P = .004), and a trend toward lower hospital mortality (29% vs 45%, P = .2) compared to the NO ATS group. Conclusions: The use of IV ascorbic acid, thiamine, and hydrocortisone might be beneficial in patients with SS.