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...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2018-01-01
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| Series: | Indian Journal of Anaesthesia |
| Subjects: | |
| Online Access: | http://www.ijaweb.org/article.asp?issn=0019-5049;year=2018;volume=62;issue=12;spage=934;epage=939;aulast=Balakrishnan |
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| author | Mahesh Balakrishnan Hemang Gandhi Komal Shah Himani Pandya Ramesh Patel Sunny Keshwani Nikhil Yadav |
| author_facet | Mahesh Balakrishnan Hemang Gandhi Komal Shah Himani Pandya Ramesh Patel Sunny Keshwani Nikhil Yadav |
| author_sort | Mahesh Balakrishnan |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-12-12T03:32:28Z |
| format | Article |
| id | doaj.art-aaa74e7a0e4e487698dd944d47852f20 |
| institution | Directory Open Access Journal |
| issn | 0019-5049 0976-2817 |
| language | English |
| last_indexed | 2024-12-12T03:32:28Z |
| publishDate | 2018-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Anaesthesia |
| spelling | doaj.art-aaa74e7a0e4e487698dd944d47852f202022-12-22T00:39:53ZengWolters Kluwer Medknow PublicationsIndian Journal of Anaesthesia0019-50490976-28172018-01-01621293493910.4103/ija.IJA_361_18Hydrocortisone, Vitamin C and thiamine for the treatment of sepsis and septic shock following cardiac surgeryMahesh BalakrishnanHemang GandhiKomal ShahHimani PandyaRamesh PatelSunny KeshwaniNikhil YadavBackground 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.http://www.ijaweb.org/article.asp?issn=0019-5049;year=2018;volume=62;issue=12;spage=934;epage=939;aulast=BalakrishnanCardiac surgeryprocalcitoninsepsisseptic shockthiaminevitamin C |
| spellingShingle | Mahesh Balakrishnan Hemang Gandhi Komal Shah Himani Pandya Ramesh Patel Sunny Keshwani Nikhil Yadav Hydrocortisone, Vitamin C and thiamine for the treatment of sepsis and septic shock following cardiac surgery Indian Journal of Anaesthesia Cardiac surgery procalcitonin sepsis septic shock thiamine vitamin C |
| 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 | Cardiac surgery procalcitonin sepsis septic shock thiamine vitamin C |
| url | http://www.ijaweb.org/article.asp?issn=0019-5049;year=2018;volume=62;issue=12;spage=934;epage=939;aulast=Balakrishnan |
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