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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Vydáno v:Critical care (London, England) Ročník 22; číslo 1; s. 283 - 7
Hlavní autoři: 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.
Médium: Journal Article
Jazyk:angličtina
Vydáno: London BioMed Central 29.10.2018
BMC
Témata:
Adrenal Cortex Hormones - pharmacology
Adrenal Cortex Hormones - therapeutic use
Anti-Bacterial Agents - adverse effects
Anti-Bacterial Agents - therapeutic use
Ascorbic acid
Ascorbic Acid - pharmacology
Ascorbic Acid - therapeutic use
Corticosteroids
Critical Care Medicine
Drug Therapy, Combination - methods
Drug Therapy, Combination - standards
Emergency Medicine
Humans
Hydrocortisone - pharmacology
Hydrocortisone - therapeutic use
Intensive
Medicine
Medicine & Public Health
Metabolic resuscitation
Models, Biological
Review
Sepsis
Sepsis - drug therapy
Thiamine
Thiamine - pharmacology
Thiamine - therapeutic use
Sepsis
Ascorbic acid
Corticosteroids
Thiamine
Metabolic resuscitation
ISSN:1364-8535, 1466-609X, 1364-8535, 1466-609X
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Abstract 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.
AbstractList 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.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.
Abstract 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.
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.
ArticleNumber 283
Author Cocchi, Michael N.
Becker, Lance B.
Andersen, Lars W.
Gong, Jonathan
Sherwin, Robert L.
Berg, Katherine M.
Donnino, Michael W.
Marik, Paul E.
Huang, David T.
Moskowitz, Ari
Grossestreuer, Anne V.
Hou, Peter C.
Sen, Ayan
Doshi, Pratik
Author_xml – sequence: 1
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  surname: Moskowitz
  fullname: Moskowitz, Ari
  organization: Beth Israel Deaconess Medical Center, Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine
– sequence: 2
  givenname: Lars W.
  surname: Andersen
  fullname: Andersen, Lars W.
  organization: Beth Israel Deaconess Medical Center, Department of Emergency Medicine, Research Center for Emergency Medicine, Aarhus University Hospital, Department of Anesthesiology, Aarhus University Hospital
– sequence: 3
  givenname: David T.
  surname: Huang
  fullname: Huang, David T.
  organization: Department of Critical Care Medicine, University of Pittsburgh, Department of Emergency Medicine, University of Pittsburgh
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  givenname: Katherine M.
  surname: Berg
  fullname: Berg, Katherine M.
  organization: Beth Israel Deaconess Medical Center, Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine
– sequence: 5
  givenname: Anne V.
  surname: Grossestreuer
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  organization: Beth Israel Deaconess Medical Center, Department of Emergency Medicine
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  organization: Department of Internal Medicine, Eastern Virginia Medical School
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  surname: Sherwin
  fullname: Sherwin, Robert L.
  organization: Department of Emergency Medicine, Wayne State University School of Medicine/Detroit Receiving Hospital
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  givenname: Peter C.
  surname: Hou
  fullname: Hou, Peter C.
  organization: Division of Emergency Critical Care Medicine, Department of Emergency Medicine, Brigham and Women’s Hospital
– sequence: 9
  givenname: Lance B.
  surname: Becker
  fullname: Becker, Lance B.
  organization: Department of Emergency Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Feinstein Institute for Medical Research
– sequence: 10
  givenname: Michael N.
  surname: Cocchi
  fullname: Cocchi, Michael N.
  organization: Beth Israel Deaconess Medical Center, Department of Emergency Medicine, Department of Anesthesia Critical Care, Division of Critical Care, Beth Israel Deaconess Medical Center
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– sequence: 12
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  surname: Gong
  fullname: Gong, Jonathan
  organization: Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health System
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  surname: Sen
  fullname: Sen, Ayan
  organization: Department of Critical Care Medicine, Mayo Clinic
– sequence: 14
  givenname: Michael W.
  surname: Donnino
  fullname: Donnino, Michael W.
  email: mdonnino@bidmc.harvard.edu, amoskowi@bidmc.harvard.edu
  organization: Beth Israel Deaconess Medical Center, Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Emergency Medicine
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Issue 1
Keywords Sepsis
Ascorbic acid
Corticosteroids
Thiamine
Metabolic resuscitation
Language English
License Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
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PublicationDate_xml – month: 10
  year: 2018
  text: 2018-10-29
  day: 29
PublicationDecade 2010
PublicationPlace London
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PublicationTitle Critical care (London, England)
PublicationTitleAbbrev Crit Care
PublicationTitleAlternate Crit Care
PublicationYear 2018
Publisher BioMed Central
BMC
Publisher_xml – name: BioMed Central
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Snippet The combination of thiamine, ascorbic acid, and hydrocortisone has recently emerged as a potential adjunctive therapy to antibiotics, infectious source...
Abstract The combination of thiamine, ascorbic acid, and hydrocortisone has recently emerged as a potential adjunctive therapy to antibiotics, infectious...
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SubjectTerms Adrenal Cortex Hormones - pharmacology
Adrenal Cortex Hormones - therapeutic use
Anti-Bacterial Agents - adverse effects
Anti-Bacterial Agents - therapeutic use
Ascorbic acid
Ascorbic Acid - pharmacology
Ascorbic Acid - therapeutic use
Corticosteroids
Critical Care Medicine
Drug Therapy, Combination - methods
Drug Therapy, Combination - standards
Emergency Medicine
Humans
Hydrocortisone - pharmacology
Hydrocortisone - therapeutic use
Intensive
Medicine
Medicine & Public Health
Metabolic resuscitation
Models, Biological
Review
Sepsis
Sepsis - drug therapy
Thiamine
Thiamine - pharmacology
Thiamine - therapeutic use
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Title Ascorbic acid, corticosteroids, and thiamine in sepsis: a review of the biologic rationale and the present state of clinical evaluation
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