Podcast 544: C is for Sepsis

<p> </p> <p><strong>Author: Aaron Lessen, MD</strong></p> <p><strong>Educational Pearls:</strong></p> <ul> <li style="font-weight: 400;"><span style= "font-weight: 400;">Previously, trials had shown promising evidence that vitamin C may improve mortality rates in patients with sepsis or septic shock.  </span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">A 2017 retrospective before-after study gave a “cocktail” of hydrocortisone, vitamin C, and thiamine to patients with severe sepsis or in septic shock and reported a decrease in mortality from 40% to 8%. </span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">A 2020 randomized controlled trial demonstrated that giving patients hydrocortisone, vitamin C, and thiamine showed no benefits in improving sepsis outcomes. </span></li> <li style="font-weight: 400;"><span style= "font-weight: 400;">Currently use of Vitamin C in sepsis and septic shock remains controversial due to lack of sufficient data</span></li> </ul> <p> </p> <p><strong>References</strong></p> <p><a href= "https://www-ncbi-nlm-nih-gov.libproxy.tulane.edu/pubmed/?term=Hydrocortisone%2C+Vitamin+C%2C+and+Thiamine+for+the+Treatment+of+Severe+Sepsis+and+Septic+Shock%3A+A+Retrospective+Before-After+Study."> <span style="font-weight: 400;">1<span style= "font-size: 10pt;">)</span></span></a> <span style= "font-weight: 400; font-size: 10pt;">Marik PE, Khangoora V, Rivera R, Hooper MH, Catravas J. Hydrocortisone, Vitamin C, and Thiamine for the Treatment of Severe Sepsis and Septic Shock: A Retrospective Before-After Study. Chest. 2017;151(6):1229. Epub 2016 Dec 6.  </span></p> <p><span style="font-size: 10pt;"><a href= "https://www-ncbi-nlm-nih-gov.libproxy.tulane.edu/pubmed/?term=Effect+of+Vitamin+C%2C+Hydrocortisone%2C+and+Thiamine+vs+Hydrocortisone+Alone+on+Time+Alive+and+Free+of+Vasopressor+Support+Among+Patients+With+Septic+Shock%3A+The+VITAMINS+Randomized+Clinical+Trial."> <span style="font-weight: 400;">2)</span></a> <span style= "font-weight: 400;">Fujii T, Lueth