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Cited by 887Sepsis Diagnosis and TreatmentVitamin C and Antioxidants ResearchHyperglycemia and glycemic control in critically ill and hospitalized patients

The DOI matches its Crossref record, with a small difference in title or year; 95 of the 95 references it cites were found in a registry or an index.

Hydrocortisone, Vitamin C, and Thiamine for the Treatment of Severe Sepsis and Septic Shock

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Marik, Paul E., Khangoora, Vikramjit, Rivera, Racquel, Hooper, Michael H., Catravas, John·2017·Chest
DOI 10.1016/j.chest.2016.11.036
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Abstract

Background The global burden of sepsis is estimated as 15 to 19 million cases annually, with a mortality rate approaching 60% in low-income countries.Methods In this retrospective before-after clinical study, we compared the outcome and clinical course of consecutive septic patients treated with intravenous vitamin C, hydrocortisone, and thiamine during a 7-month period (treatment group) with a control group treated in our ICU during the preceding 7 months. The primary outcome was hospital survival. A propensity score was generated to adjust the primary outcome.Results There were 47 patients in both treatment and control groups, with no significant differences in baseline characteristics between the two groups. The hospital mortality was 8.5% (4 of 47) in the treatment group compared with 40.4% (19 of 47) in the control group (P < .001). The propensity adjusted odds of mortality in the patients treated with the vitamin C protocol was 0.13 (95% CI, 0.04-0.48; P = .002). The Sepsis-Related Organ Failure Assessment score decreased in all patients in the treatment group, with none developing progressive organ failure. All patients in the treatment group were weaned off vasopressors, a mean of 18.3 ± 9.8 h after starting treatment with the vitamin C protocol. The mean duration of vasopressor use was 54.9 ± 28.4 h in the control group (P < .001).Conclusions Our results suggest that the early use of intravenous vitamin C, together with corticosteroids and thiamine, are effective in preventing progressive organ dysfunction, including acute kidney injury, and in reducing the mortality of patients with severe sepsis and septic shock. Additional studies are required to confirm these preliminary findings.

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Research works printed but not linked: 4

  1. de Grooth, 2016, Pharmacokinetics of four high-dose regime[n]s of intravenous vitamin C in critically ill patients, Intensive Care Med Exp, 4, A52
  2. Zabet, 2016, Effect of high-dose ascorbic acid on vasopressor requirement in septic shock, J Res Pharm Pract, 5, 94
  3. Marik, 2008, Selection bias negates conclusions from the CORTICUS study?, N Engl J Med, 358, 2069
  4. Barabutis N, Khangoora V, Marik PE, et al. Hydrocortisone and ascorbic acid synergistically protect against LPS-induced pulmonary endothelial barrier dysfunction. Chest. In press.

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Metadata

Authors
Marik, P. E., Khangoora, V., Rivera, R., Hooper, M. H., & Catravas, J.
Affiliations
  • Eastern Virginia Medical School (US)
  • Sentara Norfolk General Hospital (US)
Corresponding author
Marik, Paul E.
ORCID
Venue
Chest
Publisher
Elsevier BV
Published
2017-06
Volume
151
Issue
6
Pages
1229-1238
ISSN
0012-3692 (ISSN-L)
DOI
10.1016/j.chest.2016.11.036
OpenAlex
W2560240742
Semantic Scholar
1d6972ac35fc0d34a615e58cb9faf40d7e6f28cd
Cited by
887
References
95
Citations by year
2026: 28 · 2025: 55 · 2024: 48 · 2023: 87 · 2022: 121 · 2021: 158 · 2020: 151 · 2019: 103 · 2018: 90 · 2017: 45
FWCI
74.27
Type
journal article
Language
en
Update notices
addendum (2023-07-01)
Open access
Licence
Locations
  • CHEST Journal (publishedVersion)
  • PubMed (publishedVersion)
  • ODU Digital Commons (Old Dominion University) (submittedVersion)
Topics
  • Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Sepsis Diagnosis and Treatment
  • Health Sciences › Nursing › Nutrition and Dietetics › Vitamin C and Antioxidants Research
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hyperglycemia and glycemic control in critically ill and hospitalized patients
Keywords
severe sepsis, septic shock, cortisol, intravenous vitamin C, thiamine, corticosteroids, in-hospital mortality, organ dysfunction, acute kidney injury, vasopressor weaning, sepsis-related organ failure assessment
MeSH terms
Adult, Aged, Anti-Inflammatory Agents, Antioxidants, Ascorbic Acid, Drug Therapy, Combination, Female, Humans, Hydrocortisone, Intensive Care Units, Male, Middle Aged, Retrospective Studies, Shock, Septic, Thiamine, Vasoconstrictor Agents, Vitamin B Complex, Treatment Outcome, Hospital Mortality, Sepsis, Acute Kidney Injury, Administration, Intravenous, Controlled Before-After Studies

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