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29 maart 2020: Bron: Chest Journal

Infusen met vitamine C plus hydrocortisone en thiamin verminderde het aantal doden aanzienlijk bij patiënten opgenomen met sepsis en septische shock. het verschil in aantal doden na 7 maanden voor de 2 groepen van 47 patiënten elk was 8.5% (4 of 47) in de behandelingsgroep vergeleken met 40.4% (19 of 47) in de controle groep (P < .001).

In een retrospectieve klinische studie vóór en na vergeleken onderzoekers de uitkomst en het klinische verloop van septische patiënten die gedurende 7 maanden (behandelingsgroep) werden behandeld met intraveneuze vitamine C, hydrocortison en thiamine, met een controlegroep die op hun IC - Intensive Care werd behandeld tijdens de voorafgaande 7 maanden. Het primaire doel was te zien of er verschil in overleving zou zijn bij de twee patiëntengroepen in het ziekenhuis. 

De gecorrigeerde kans op sterfte bij de patiënten behandeld met het vitamine C-protocol was 0,13 (95% BI, 0,04-0,48; P = 0,002). De Sepsis-gerelateerde score voor orgaanfalen nam af bij alle patiënten in de behandelingsgroep, waarbij geen enkele patiënt een progressief orgaanfalen ontwikkelde.

Het volledige studierapport: Hydrocortisone, Vitamin C, and Thiamine for the Treatment of Severe Sepsis and Septic Shock is tegen betaling in te zien.

Hier het abstract van de studie:

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

A Retrospective Before-After Study

Paul E. Marik, MD, FCCPa,,'Correspondence information about the author MD, FCCP Paul E. Marik
Vikramjit Khangoora, MDa
Racquel Rivera, PharmDb
Michael H. Hooper, MDa
John Catravas, PhD, FCCPc,d

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.

Referenties

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FUNDING/SUPPORT: The authors have reported to CHEST that no funding was received for this study.


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