Benefits of combination therapy of hydrocortisone, ascorbic acid and thiamine in sepsis and septic shock: A systematic review.

@article{Lee2021BenefitsOC,
  title={Benefits of combination therapy of hydrocortisone, ascorbic acid and thiamine in sepsis and septic shock: A systematic review.},
  author={Young Ran Lee and Kandace Vo and Jincy Thazhampallatu Varughese},
  journal={Nutrition and health},
  year={2021},
  pages={
          2601060211018371
        }
}
BACKGROUND Sepsis and septic shock are severe medical conditions that can damage multiple organs with a higher risk of mortality. Recently, the combination of hydrocortisone, ascorbic acid and thiamine (HAT) was hypothesized to work synergistically to reverse septic shock and reduce mortality. AIM To ascertain the efficacy of HAT therapy and compare whether HAT therapy is more beneficial compared to the standard of care in sepsis and septic shock patients. METHODS PubMed, Clinicaltrials.gov… Expand

References

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Vitamin C, Hydrocortisone, and Thiamine for the Treatment of Severe Sepsis and Septic Shock: A Retrospective Analysis of Real-World Application
TLDR
A randomized controlled trial evaluating the effects of triple therapy is necessary prior to implementing vitamin C, hydrocortisone, and thiamine combination therapy as a standard of care in patients with septic shock. Expand
Effect of Ascorbic Acid, Corticosteroids, and Thiamine on Organ Injury in Septic Shock: The ACTS Randomized Clinical Trial.
TLDR
The combination of ascorbic acid, corticosteroids, and thiamine, compared with placebo, did not result in a statistically significant reduction in SOFA score during the first 72 hours after enrollment, and these data do not support routine use of this combination therapy for patients with septic shock. Expand
Hydrocortisone, Vitamin C, and Thiamine for the Treatment of Severe Sepsis and Septic Shock: A Retrospective Before‐After Study
TLDR
The 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. Expand
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TLDR
The results suggest that the combination of intravenous ascorbic acid, thiamine, and hydrocortisone significantly reduced the time to resolution of shock. Expand
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TLDR
Vitamin C and thiamine administration in the early phase of septic shock did not improve organ function compared with placebo, despite improvements in vitamin C andThiamine levels. Expand
Effect of Vitamin C, Hydrocortisone, and Thiamine vs Hydrocortisone Alone on Time Alive and Free of Vasopressor Support Among Patients With Septic Shock: The VITAMINS Randomized Clinical Trial.
TLDR
Treatment with intravenous vitamin C, hydrocortisone, and thiamine did not significantly improve the duration of time alive and free of vasopressor administration in patients with septic shock, suggesting that treatment with the combination does not lead to a more rapid resolution of septicshock. Expand
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TLDR
Combined vitamin C, hydrocortisone, and thiamine therapy may benefit patients with severe pneumonia and is associated independently with decreased mortality in propensity score‐adjusted analysis. Expand
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TLDR
Triple therapy seems to provide an improvement of clinical outcomes in patients with refractory septic shock, and showed a trend in lowering the 30-day and hospital mortality compared to therapy with only hydrocortisone. Expand
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People of older age, male gender, black race, and preexisting chronic health conditions are particularly prone to develop severe sepsis; hence prevention strategies should be targeted at these vulnerable populations in future studies. Expand
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