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Cited 94 time in webofscience Cited 99 time in scopus
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Combination therapy of vitamin C and thiamine for septic shock: a multi-centre, double-blinded randomized, controlled study

Authors
Hwang, Sung YeonRyoo, Seung MokPark, Jong EunJo, You HwanJang, Dong-HyunSuh, Gil JoonKim, TaegyunKim, Youn-JungKim, SeonwooCho, HyunJo, Ik JoonChung, Sung PhilChoi, Sung-HyukShin, Tae GunKim, Won Young
Issue Date
Nov-2020
Publisher
Springer Verlag
Keywords
Sepsis; Septic shock; Thiamine; Vitamin C; Resuscitation
Citation
Intensive Care Medicine, v.46, no.11, pp 2015 - 2025
Pages
11
Indexed
SCIE
SCOPUS
Journal Title
Intensive Care Medicine
Volume
46
Number
11
Start Page
2015
End Page
2025
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/33937
DOI
10.1007/s00134-020-06191-3
ISSN
0342-4642
1432-1238
Abstract
Purpose To evaluate the effects of early combination therapy with intravenous vitamin C and thiamine on recovery from organ failure in patients with septic shock. Methods The ascorbic acid and thiamine effect in septic shock (ATESS) trial was a multi-centre, double-blind, randomized, controlled trial conducted in four academic emergency departments, enrolling adult patients with septic shock from December 2018 through January 2020. Patients were randomly assigned in a 1:1 ratio to either the treatment group [intravenous vitamin C (50 mg/kg, maximum single dose 3 g) and thiamine (200 mg) administration every 12 h for a total of 48 h] or the placebo group (identical volume of 0.9% saline with the same protocol). The primary outcome was Delta Sequential Organ Failure Assessment (SOFA) score (SOFA score at enrolment-SOFA score after 72 h). Eighteen secondary outcomes were predefined, including shock reversal and 28-day mortality. Results A total of 111 patients were enrolled, of which 53 were assigned to the treatment group and 58 were assigned to the placebo group. There was no significant difference in Delta SOFA scores between the treatment group and the placebo group [3, interquartile range (IQR) - 1 to 5 vs. 3, IQR 0-4, respectively,p = 0.96]. Predefined secondary outcomes were also not significantly different between the groups. Conclusion In this study, 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 and thiamine levels.
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Choi, Sung Hyuk
Guro Hospital (Department of Emergency Medicine, Guro Hospital)
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