医学
硫胺素
重症监护医学
维生素
随机对照试验
败血症
维生素C
氢化可的松
感染性休克
休克(循环)
临床试验
内科学
生理学
作者
Tomoko Fujii,Adam M. Deane,Priya Nair
出处
期刊:Current Opinion in Critical Care
[Ovid Technologies (Wolters Kluwer)]
日期:2020-08-01
卷期号:Publish Ahead of Print
被引量:5
标识
DOI:10.1097/mcc.0000000000000736
摘要
Purpose of review Sepsis is a global health issue, and there is a need for effective, low-cost adjunct metabolic treatments. Corticosteroids have been investigated in many trials for decades, and recently the administration of vitamin C, thiamine (vitamin B1), and vitamin D have been proposed as novel therapies in patients with sepsis. Recent findings APROCCHSS (N = 1241) and ADRENAL (N = 3800) trial reported inconsistent results in mortality outcome; however, both demonstrated a decreased duration of shock with low-dose corticosteroids. The CITRIS-ALI trial (N = 170) examined the effects of intravenous vitamin C 200 mg/kg/day and reported no effect on organ dysfunction or biomarkers. The VITAMINS trial (N = 216) compared combination therapy of vitamin C 6 g/day, thiamine 200 mg/day, and hydrocortisone 200 mg/day with hydrocortisone alone to find that the combination did not increase vasopressor free time. A single trial (N = 88) evaluating the effect of thiamine in patients with sepsis reported a neutral result. Two randomized trials (N = 475 and N = 1360) on the supplementation of vitamin D in the critically ill patients did not identify statistically significant reduction in mortality. Summary Evidence from high-quality research is still insufficient to support the use of vitamin C, thiamine, and vitamin D as metabolic support in sepsis treatment.
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