Vitamins With Corticosteroids Not Effective For Septic Shock
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A combination of vitamins C and B1 with corticosteroids didn't protect the organs in septic shock, the ACTS trial showed.

This study aimed to determine whether the combination of ascorbic acid, corticosteroids, and thiamine attenuates organ injury in patients with septic shock.

Randomized, blinded, multicenter clinical trial of ascorbic acid, corticosteroids, and thiamine vs placebo for adult patients with septic shock was conducted. Patients were randomly assigned to receive parenteral ascorbic acid (1500 mg), hydrocortisone (50 mg), and thiamine (100 mg) every 6 hours for 4 days or placebo.

The trial included 205 adults with septic shock randomized at 14 U.S. medical centers (mean age 68, 44% women). Other treatment followed local sepsis management guidelines, with recommendation of early antibiotics, keeping mean arterial pressure to at least 65 mm Hg with a combination of volume resuscitation and vasopressors, and early treatment of the source of infection.

Among secondary endpoints, incidence of kidney failure was 31.7% with the intervention versus 27.3% with placebo. Mortality at 30 days was 34.7% and 29.3%, respectively.

Median ventilator-free days in the first week after enrollment was 6 in both groups, but shock-free days was 5 with intervention versus 4 without, which did reach statistical significance. Cardiovascular SOFA score also favored the intervention by 0.5 points.

Conclusively, In patients with septic shock, the combination of ascorbic acid, corticosteroids, and thiamine, compared with placebo, did not result in a statistically significant reduction in SOFA score during the first 72 hours after enrollment. These data do not support routine use of this combination therapy for patients with septic shock.

Source: https://jamanetwork.com/journals/jama/article-abstract/2769467
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