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Revista de la OFIL
On-line version ISSN 1699-714XPrint version ISSN 1131-9429
Abstract
ANGUITA-MONTENEGRO, B et al. Vitamin C, thiamine and hydrocortisone: allies against septic shock?. Rev. OFIL·ILAPHAR [online]. 2023, vol.33, n.2, pp.154-158. Epub Mar 04, 2024. ISSN 1699-714X. https://dx.doi.org/10.4321/s1699-714x2023000200010.
Objective:
To determine the effectiveness of using a protocol of vitamin C, thiamine and hydrocortisone for the treatment of septic shock at the doses used in the Marik study.
Methods:
Retrospective observational before-after study comparing two groups of patients with septic shock: treatment group (GT), treated with the protocol, between January 2019 and May 2020, versus a control group (GC) in a previous period. The primary outcomes were 14-Day and 28-Day Survival.
Results:
91 patients were included, 44 in GC and 47 in GT. No statistically significant differences were found in 14day and 28-day survival, in length of hospital or Resuscitation Unit (REA) stay (p>0.05).
The median creatinine variation between days 1 and 4 was -0.04 (IQR -0.24;0.8) in the GC vs -0.3 in the GT (IQR -0.079; -0.03) (p<0.05). Procalcitonin values decreased in 27.3% of GC versus 91.5% of GT (p<0.05). The need for vasoactive drugs (noradrenaline) was 93% in GC vs 76.6% GT on day 2; 75% GC vs 55.3% GT on day 3; 50% GC vs 27.7% GT on day 4 (p<0.05).
Conclusions:
Our results show a limited benefit of the use of the protocol in patients with septic shock, but larger recruitment studies with a prospective randomized design are needed to ensure real benefit and/or optimal doses.
Keywords : Vitamin C; thiamine; hydrocortisone; septic shock; surgical patient.