Aug 1, 2020
Metabolic support in sepsis: corticosteroids and vitamins: the why, the when, the how
Current opinion in critical care
- ,
- ,
- Volume
- 26
- Number
- 4
- First page
- 363
- Last page
- 368
- Language
- Publishing type
- Research paper (scientific journal)
- 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.
- Link information
- ID information
-
- DOI : 10.1097/MCC.0000000000000736
- eISSN : 1531-7072
- Pubmed ID : 32487845
- SCOPUS ID : 85087530659