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Original Articles

Combination of vitamin C, thiamine and hydrocortisone added to standard treatment in the management of sepsis: results from an open label randomised controlled clinical trial and a review of the literature

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Pages 271-278 | Received 01 Nov 2019, Accepted 13 Jan 2020, Published online: 28 Jan 2020

Keep up to date with the latest research on this topic with citation updates for this article.

Read on this site (2)

Yuan-yuan Xu, Cheng-zhu Xu, You-feng Liang, Dan-qun Jin, Jie Ding, Yao Sheng, Le Zhang & Fang Deng. (2022) Ascorbic acid and hydrocortisone synergistically inhibit septic organ injury via improving oxidative stress and inhibiting inflammation. Immunopharmacology and Immunotoxicology 44:5, pages 786-794.
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Richard R. Watkins, Robert A. Bonomo & Jordi Rello. (2022) Managing sepsis in the era of precision medicine: challenges and opportunities. Expert Review of Anti-infective Therapy 20:6, pages 871-880.
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Articles from other publishers (51)

Yali Sun, Yongfang Yang, Zhuoyi Ye & Tongwen Sun. (2023) HAT therapy for sepsis: A review of the therapeutic rationale and current clinical evaluation status. Journal of Intensive Medicine 3:4, pages 320-325.
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Egle Belousoviene, Zivile Pranskuniene, Egle Vaitkaitiene, Vidas Pilvinis & Andrius Pranskunas. (2023) Effect of high-dose intravenous ascorbic acid on microcirculation and endothelial glycocalyx during sepsis and septic shock: a double-blind, randomized, placebo-controlled study. BMC Anesthesiology 23:1.
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Huoyan Liang, Qingqing Mu, Wenju Sun, Liming Liu, Simin Qiu, Zili Xu, Yuqing Cui, Yan Yan & Tongwen Sun. (2023) Effect of intravenous vitamin C on adult septic patients: a systematic review and meta-analysis. Frontiers in Nutrition 10.
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Kunkun Wang, Ling Yin, Yang Song, Mengqi Zhang, Yun Lu & Shan Wang. (2022) The Use of Hydrocortisone, Ascorbic Acid and Thiamine in Patients with Sepsis and Septic Shock – A Systematic Review. Journal of Pharmacy Practice 36:4, pages 933-940.
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Jinlong Wang, Qianwen Song, Shuhe Yang, Haofei Wang, Shanshan Meng, Lili Huang, Qing Li, Jingyuan Xu, Jianfeng Xie & Yingzi Huang. (2023) Effects of hydrocortisone combined with vitamin C and vitamin B1 versus hydrocortisone alone on microcirculation in septic shock patients: A pilot study. Clinical Hemorheology and Microcirculation 84:2, pages 111-123.
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Paul A. Blakeslee & Kristiina Hyrkäs. (2023) Impact of supplemental thiamin on lactate levels in adults with septic shock. Nutrition in Clinical Practice 38:3, pages 580-601.
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Juan Novoa, Gil Hardy & William Manzanares. (2023) Thiamine pharmaconutrition in sepsis: Monotherapy, combined therapy, or neither? Current evidence on safety and efficacy. Nutrition 109, pages 112000.
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Baofang Liang, Jianwei Su, Hanquan Shao, Huiying Chen & Baocheng Xie. (2023) The outcome of IV vitamin C therapy in patients with sepsis or septic shock: a meta-analysis of randomized controlled trials. Critical Care 27:1.
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Chengli Wen, Yuan Li, Qinxue Hu, Hui Liu, Xinxin Xu & Muhan Lü. (2023) IV Vitamin C in Sepsis: A Latest Systematic Review and Meta-Analysis. International Journal of Clinical Practice 2023, pages 1-15.
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Sudaryadi Sudaryadi, Eddy Harijanto & Indro Mulyono. (2023) Comparison of Hydrocortisone with Combined Hydrocortisone, Ascorbic Acid, and Thiamine as an Adjuvant Therapy on Septic Shock Patients on Mortality: A Systematic Review and Meta-analysis. Open Access Macedonian Journal of Medical Sciences 11:F, pages 171-179.
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Zhuangli Li, Xiaoli Zhang, Yongliang Wu, Chao Xie, Chengjiang Liu, Xiuyu He, Zehua Wu, Guofang Hua & Yuedong Li. (2023) Hydrocortisone, vitamin C, and thiamine may not improve the outcome of patients with sepsis or septic shock: a systematic review and meta-analysis. Emergency and Critical Care Medicine Publish Ahead of Print.
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Katherine Kozarek & Diane Head. 2023. Evidence-Based Practice of Anesthesiology. Evidence-Based Practice of Anesthesiology 217 225 .
Jonathan Brown, Cassie Robertson, Luis Sevilla, Jorge Garza, Hytham Rashid, Ana C Benitez, Mikhail Shipotko & Zuhair Ali. (2022) A Systematic Review and Meta-Analysis on Possible Role of Vitamin C in Sepsis. Cureus.
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Nafiseh Shokri-mashhadi, Ali Aliyari, Zahra Hajhashemy, Saeed Saadat & Mohammad Hossein Rouhani. (2022) Is it time to reconsider the administration of thiamine alone or in combination with vitamin C in critically ill patients? A meta-analysis of clinical trial studies. Journal of Intensive Care 10:1.
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Patrice Rosengrave, Emma Spencer, Jonathan Williman, Jan Mehrtens, Stacey Morgan, Tara Doyle, Kymbalee Van Der Heyden, Anna Morris, Geoff Shaw & Anitra C. Carr. (2022) Intravenous vitamin C administration to patients with septic shock: a pilot randomised controlled trial. Critical Care 26:1.
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Deven Juneja, Prashant Nasa & Ravi Jain. (2022) Current role of high dose vitamin C in sepsis management: A concise review. World Journal of Critical Care Medicine 11:6, pages 349-363.
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Ching-Yi Chen, Chien-Tung Chiu, Ho-Sheng Lee & Chih-Cheng Lai. (2022) The impact of vitamin C-containing treatment on the mortality of patients with sepsis: a systematic review and meta-analysis of randomized controlled trials. Journal of Infection and Public Health.
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Ana Luiza Cabrera Martimbianco, Rafael Leite Pacheco, Ângela Maria Bagattini, Roberta de Fátima Carreira Moreira Padovez, Luciano Cesar Pontes Azevedo & Rachel Riera. (2022) Vitamin C-based regimens for sepsis and septic shock: Systematic review and meta-analysis of randomized clinical trials.. Journal of Critical Care 71, pages 154099.
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Qing-Quan Lyu, Rui-Qiang Zheng, Qi-Hong Chen, Jiang-Quan Yu, Jun Shao & Xiao-Hua Gu. (2022) Early administration of hydrocortisone, vitamin C, and thiamine in adult patients with septic shock: a randomized controlled clinical trial. Critical Care 26:1.
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Qing Zhao, Jianguo Xiao & Hui Liu. (2022) No benefit of hydrocortisone, ascorbic acid, and thiamine in reducing mortality in adult sepsis patients: a systematic review and meta-analysis. Emergency and Critical Care Medicine 2:3, pages 167-174.
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Xiaolu Li, Yanyan Yang, Bei Zhang, Xiaotong Lin, Xiuxiu Fu, Yi An, Yulin Zou, Jian-Xun Wang, Zhibin Wang & Tao Yu. (2022) Lactate metabolism in human health and disease. Signal Transduction and Targeted Therapy 7:1.
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Arnav Agarwal, John Basmaji, Shannon M. Fernando, Fang Zhou Ge, Yingqi Xiao, Haseeb Faisal, Kimia Honarmand, Mathieu Hylands, Vincent Lau, Kimberley Lewis, Rachel Couban, François Lamontagne & Neill K. J. Adhikari. (2022) Parenteral Vitamin C in Patients with Severe Infection: A Systematic Review. NEJM Evidence 1:9.
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Jihad Mallat, Nadeem Rahman, Fadi Hamed, Glenn Hernandez & Marc-Olivier Fischer. (2022) Pathophysiology, mechanisms, and managements of tissue hypoxia. Anaesthesia Critical Care & Pain Medicine 41:4, pages 101087.
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Marwah Muhammad, Ahmad Jahangir, Ali Kassem, Saud Bin Abdul Sattar, Abdullah Jahangir, Syeda Sahra, Muhammad Rafay Khan Niazi, Ahmad Mustafa, Zeeshan Zia, Fasih Sami Siddiqui, Waleed Sadiq, Danil Mishiyev, Aleena Sammar, Loai Dahabra, Aazib Irshad, Dany Elsayegh & Michel Chalhoub. (2022) The Role and Efficacy of Vitamin C in Sepsis: A Systematic Review and Meta-Analysis. Advances in Respiratory Medicine 90:4, pages 281-299.
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Stuart Feichtinger, Angélique de Man, Adam A. Dalia, Molly K. Groose & Micah T. Long. (2022) Sepsis and Resuscitation: The Importance of Time. Critical Care Medicine 50:6, pages e615-e616.
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David A. WackerSusan L. BurtonJohn P. BergerA. J. HeggJamie HeisdorfferQi WangEmily J. MedcraftRonald A. Reilkoff. (2022) Evaluating Vitamin C in Septic Shock: A Randomized Controlled Trial of Vitamin C Monotherapy*. Critical Care Medicine 50:5, pages e458-e467.
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Dagan Coppock, Pierre-Christian Violet, Gustavo Vasquez, Katherine Belden, Michael Foster, Bret Mullin, Devon Magee, Isabelle Mikell, Lokesh Shah, Victoria Powers, Brian Curcio, Daniel Monti & Mark Levine. (2022) Pharmacologic Ascorbic Acid as Early Therapy for Hospitalized Patients with COVID-19: A Randomized Clinical Trial. Life 12:3, pages 453.
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Jayshil J. Patel, Alfonso Ortiz-Reyes, Rupinder Dhaliwal, John Clarke, Aileen Hill, Christian Stoppe, Zheng-Yii Lee & Daren K. Heyland. (2021) IV Vitamin C in Critically Ill Patients: A Systematic Review and Meta-Analysis. Critical Care Medicine 50:3, pages e304-e312.
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Nara Aline Costa, Amanda Gomes Pereira, Clara Sandra Araujo Sugizaki, Nayane Maria Vieira, Leonardo Rufino Garcia, Sérgio Alberto Rupp de Paiva, Leonardo Antonio Mamede Zornoff, Paula Schmidt Azevedo, Bertha Furlan Polegato & Marcos Ferreira Minicucci. (2022) Insights Into Thiamine Supplementation in Patients With Septic Shock. Frontiers in Medicine 8.
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Tomoko Fujii, Georgia Salanti, Alessandro Belletti, Rinaldo Bellomo, Anitra Carr, Toshi A. Furukawa, Nora Luethi, Yan Luo, Alessandro Putzu, Chiara Sartini, Yasushi Tsujimoto, Andrew A. Udy, Fumitaka Yanase & Paul J. Young. (2021) Effect of adjunctive vitamin C, glucocorticoids, and vitamin B1 on longer-term mortality in adults with sepsis or septic shock: a systematic review and a component network meta-analysis. Intensive Care Medicine 48:1, pages 16-24.
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Sander Rozemeijer, Bob Smit, Paul W. G. Elbers, Armand R. J. Girbes, Heleen M. Oudemans-van Straaten & Angelique M. E. de Man. (2021) Rapid screening of critically ill patients for low plasma vitamin C concentrations using a point-of-care oxidation–reduction potential measurement. Intensive Care Medicine Experimental 9:1.
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Weilan Na, Huili Shen, Yichu Li & Dong Qu. (2021) Hydrocortisone, ascorbic acid, and thiamine (HAT) for sepsis and septic shock: a meta-analysis with sequential trial analysis. Journal of Intensive Care 9:1.
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Sander Rozemeijer, Harm-Jan de Grooth, Paul W. G. Elbers, Armand R. J. Girbes, Corstiaan A. den Uil, Eric A. Dubois, Evert-Jan Wils, Thijs C. D. Rettig, Arthur R. H. van Zanten, Roel Vink, Bas van den Bogaard, Rob J. Bosman, Heleen M. Oudemans-van Straaten & Angélique M. E. de Man. (2021) Early high-dose vitamin C in post-cardiac arrest syndrome (VITaCCA): study protocol for a randomized, double-blind, multi-center, placebo-controlled trial. Trials 22:1.
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Sander Rozemeijer, Frans A. L. van der Horst & Angélique M. E. de Man. (2021) Measuring vitamin C in critically ill patients: clinical importance and practical difficulties—Is it time for a surrogate marker?. Critical Care 25:1.
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Sean S. Scholz, Rainer Borgstedt, Nicole Ebeling, Leoni C. Menzel, Gerrit Jansen & Sebastian Rehberg. (2021) Mortality in septic patients treated with vitamin C: a systematic meta-analysis. Critical Care 25:1.
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Tong Wu, Chang Hu, Weipeng Huang, Qiancheng Xu, Bo Hu & Jianguo Li. (2021) Effect of Combined Hydrocortisone, Ascorbic Acid and Thiamine for Patients with Sepsis and Septic Shock: A Systematic Review and Meta-Analysis. Shock 56:6, pages 880-889.
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Ting Li, Jun Zeng, Di-huan Li, Guang-yu Yang, Kai Wang, Hong-fei Deng & Hua Jiang. (2021) Efficacy of intravenous vitamin C intervention for septic patients: A systematic review and meta-analysis based on randomized controlled trials. The American Journal of Emergency Medicine 50, pages 242-250.
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Dhan Bahadur Shrestha, Pravash Budhathoki, Yub Raj Sedhai, Sujit Kumar Mandal, Shreeja Shikhrakar, Saurab Karki, Ram Kaji Baniya, Markos G. Kashiouris, Xian Qiao & Alpha A. Fowler. (2021) Vitamin C in Critically Ill Patients: An Updated Systematic Review and Meta-Analysis. Nutrients 13:10, pages 3564.
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