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Hydrocortisone, Vitamin C and thiamine for the treatment of sepsis and septic shock following cardiac surgery
BACKGROUND AND AIMS: The effect of vitamin C on vasopressor requirement in critically ill patients have been evaluated previously. We aimed to evaluate the effect of vitamin C, hydrocortisone and thiamine on vasopressor requirement and mortality in post-operative adult cardiac surgical patients with...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6299773/ https://www.ncbi.nlm.nih.gov/pubmed/30636793 http://dx.doi.org/10.4103/ija.IJA_361_18 |
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author | Balakrishnan, Mahesh Gandhi, Hemang Shah, Komal Pandya, Himani Patel, Ramesh Keshwani, Sunny Yadav, Nikhil |
author_facet | Balakrishnan, Mahesh Gandhi, Hemang Shah, Komal Pandya, Himani Patel, Ramesh Keshwani, Sunny Yadav, Nikhil |
author_sort | Balakrishnan, Mahesh |
collection | PubMed |
description | BACKGROUND AND AIMS: The effect of vitamin C on vasopressor requirement in critically ill patients have been evaluated previously. We aimed to evaluate the effect of vitamin C, hydrocortisone and thiamine on vasopressor requirement and mortality in post-operative adult cardiac surgical patients with septic shock. METHODS: About 24 patients with septic shock were randomised into Group 1 (receiving matching placebo per day for 4 days) and Group 2 (receiving 6 g vitamin C, 400 mg thiamine and 200 mg hydrocortisone per day for 4 days). Vasopressor dose over 4 days of therapy was the primary endpoint, whereas in-hospital mortality was the secondary endpoint. RESULTS: APACHE IV and EUROSCORE II scores were similar between both the groups. Significant reductions in the requirement of vasopressin (difference from day 1 – 0.0008 ± 0.00289 vs 0.0033 ± 0.00492 units/kg/min; P = 0.019) and noradrenaline (difference from day 1 – 0.0283 ± 0.040 vs 0.023 ± 0.035 μg/kg/min; P = 0.006) were observed with vitamin C treatment as compared to control group. PCT levels on Day 3 (68.11 ± 33.64 vs 33.2 ± 27.55 ng/mL; P = 0.0161) and Day 4 (70.03 ± 29.74 vs 26.3 ± 23.08 ng/mL; P = 0.0009) were significantly lower in treatment group as compared to control. However, there was no difference in the Sepsis-Related Organ Failure Assessment (SOFA) score and mortality between the studied groups. CONCLUSION: Combination of vitamin C, thiamine and hydrocortisone reduces vasopressor requirement in adult cardiac surgical patients with septic shock. |
format | Online Article Text |
id | pubmed-6299773 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-62997732019-01-11 Hydrocortisone, Vitamin C and thiamine for the treatment of sepsis and septic shock following cardiac surgery Balakrishnan, Mahesh Gandhi, Hemang Shah, Komal Pandya, Himani Patel, Ramesh Keshwani, Sunny Yadav, Nikhil Indian J Anaesth Original Article BACKGROUND AND AIMS: The effect of vitamin C on vasopressor requirement in critically ill patients have been evaluated previously. We aimed to evaluate the effect of vitamin C, hydrocortisone and thiamine on vasopressor requirement and mortality in post-operative adult cardiac surgical patients with septic shock. METHODS: About 24 patients with septic shock were randomised into Group 1 (receiving matching placebo per day for 4 days) and Group 2 (receiving 6 g vitamin C, 400 mg thiamine and 200 mg hydrocortisone per day for 4 days). Vasopressor dose over 4 days of therapy was the primary endpoint, whereas in-hospital mortality was the secondary endpoint. RESULTS: APACHE IV and EUROSCORE II scores were similar between both the groups. Significant reductions in the requirement of vasopressin (difference from day 1 – 0.0008 ± 0.00289 vs 0.0033 ± 0.00492 units/kg/min; P = 0.019) and noradrenaline (difference from day 1 – 0.0283 ± 0.040 vs 0.023 ± 0.035 μg/kg/min; P = 0.006) were observed with vitamin C treatment as compared to control group. PCT levels on Day 3 (68.11 ± 33.64 vs 33.2 ± 27.55 ng/mL; P = 0.0161) and Day 4 (70.03 ± 29.74 vs 26.3 ± 23.08 ng/mL; P = 0.0009) were significantly lower in treatment group as compared to control. However, there was no difference in the Sepsis-Related Organ Failure Assessment (SOFA) score and mortality between the studied groups. CONCLUSION: Combination of vitamin C, thiamine and hydrocortisone reduces vasopressor requirement in adult cardiac surgical patients with septic shock. Medknow Publications & Media Pvt Ltd 2018-12 /pmc/articles/PMC6299773/ /pubmed/30636793 http://dx.doi.org/10.4103/ija.IJA_361_18 Text en Copyright: © 2018 Indian Journal of Anaesthesia http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Balakrishnan, Mahesh Gandhi, Hemang Shah, Komal Pandya, Himani Patel, Ramesh Keshwani, Sunny Yadav, Nikhil Hydrocortisone, Vitamin C and thiamine for the treatment of sepsis and septic shock following cardiac surgery |
title | Hydrocortisone, Vitamin C and thiamine for the treatment of sepsis and septic shock following cardiac surgery |
title_full | Hydrocortisone, Vitamin C and thiamine for the treatment of sepsis and septic shock following cardiac surgery |
title_fullStr | Hydrocortisone, Vitamin C and thiamine for the treatment of sepsis and septic shock following cardiac surgery |
title_full_unstemmed | Hydrocortisone, Vitamin C and thiamine for the treatment of sepsis and septic shock following cardiac surgery |
title_short | Hydrocortisone, Vitamin C and thiamine for the treatment of sepsis and septic shock following cardiac surgery |
title_sort | hydrocortisone, vitamin c and thiamine for the treatment of sepsis and septic shock following cardiac surgery |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6299773/ https://www.ncbi.nlm.nih.gov/pubmed/30636793 http://dx.doi.org/10.4103/ija.IJA_361_18 |
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