論文

査読有り
2020年8月1日

Metabolic support in sepsis: corticosteroids and vitamins: the why, the when, the how

Current opinion in critical care
  • Tomoko Fujii
  • ,
  • Adam M. Deane
  • ,
  • Priya Nair

26
4
開始ページ
363
終了ページ
368
記述言語
掲載種別
研究論文(学術雑誌)
DOI
10.1097/MCC.0000000000000736

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.

リンク情報
DOI
https://doi.org/10.1097/MCC.0000000000000736
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/32487845
Scopus
https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85087530659&origin=inward
Scopus Citedby
https://www.scopus.com/inward/citedby.uri?partnerID=HzOxMe3b&scp=85087530659&origin=inward
ID情報
  • DOI : 10.1097/MCC.0000000000000736
  • eISSN : 1531-7072
  • PubMed ID : 32487845
  • SCOPUS ID : 85087530659

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