Ascorbic acid, corticosteroids, and thiamine in sepsis: a review of the biologic rationale and the present state of clinical evaluation

The combination of thiamine, ascorbic acid, and hydrocortisone has recently emerged as a potential adjunctive therapy to antibiotics, infectious source control, and supportive care for patients with sepsis and septic shock. In the present manuscript, we provide a comprehensive review of the pathophy...

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Veröffentlicht in:Critical care (London, England) Jg. 22; H. 1; S. 283 - 7
Hauptverfasser: Moskowitz, Ari, Andersen, Lars W., Huang, David T., Berg, Katherine M., Grossestreuer, Anne V., Marik, Paul E., Sherwin, Robert L., Hou, Peter C., Becker, Lance B., Cocchi, Michael N., Doshi, Pratik, Gong, Jonathan, Sen, Ayan, Donnino, Michael W.
Format: Journal Article
Sprache:Englisch
Veröffentlicht: London BioMed Central 29.10.2018
BMC
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ISSN:1364-8535, 1466-609X, 1364-8535, 1466-609X
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Zusammenfassung:The combination of thiamine, ascorbic acid, and hydrocortisone has recently emerged as a potential adjunctive therapy to antibiotics, infectious source control, and supportive care for patients with sepsis and septic shock. In the present manuscript, we provide a comprehensive review of the pathophysiologic basis and supporting research for each element of the thiamine, ascorbic acid, and hydrocortisone drug combination in sepsis. In addition, we describe potential areas of synergy between these therapies and discuss the strengths/weaknesses of the two studies to date which have evaluated the drug combination in patients with severe infection. Finally, we describe the current state of current clinical practice as it relates to the thiamine, ascorbic acid, and hydrocortisone combination and present an overview of the randomized, placebo-controlled, multi-center Ascorbic acid, Corticosteroids, and Thiamine in Sepsis (ACTS) trial and other planned/ongoing randomized clinical trials.
Bibliographie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
ObjectType-Review-3
content type line 23
ISSN:1364-8535
1466-609X
1364-8535
1466-609X
DOI:10.1186/s13054-018-2217-4