Work

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

Year: 2018

Type: review

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.

Source: Critical Care

DOI: 10.1186/s13054-018-2217-4

Authors: Ari Moskowitz, Lars W. Andersen, David T. Huang, Katherine M. Berg, Anne V. Grossestreuer, Paul E. Marik, Robert L. Sherwin, Peter C. Hou, Lance B. Becker, Michael N. Cocchi, Pratik Doshi, Jonathan Gong, Ayan Sen, Michael W. Donnino

Institutions: Beth Israel Deaconess Medical Center, Aarhus University Hospital, University of Pittsburgh, Eastern Virginia Medical School, Wayne State University, Detroit Receiving Hospital, Brigham and Women's Hospital, Feinstein Institute for Medical Research, Donald & Barbara Zucker School of Medicine at Hofstra/Northwell, The University of Texas Health Science Center at Houston, Northwell Health, Hofstra University, Mayo Clinic, Mayo Clinic Hospital

Language: English

Topic: Sepsis Diagnosis and Treatment

Subfield: Epidemiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $4,190

Funders: American Heart Association, Harvard Catalyst, Open Philanthropy Project, National Institutes of Health, National Heart, Lung, and Blood Institute, National Institute of General Medical Sciences, National Center for Research Resources, National Center for Advancing Translational Sciences

Awards: G1485268950, Acute Lung Injury Group New England Program to Support PETAL Network Research, Esmolol to Treat the Cardiovascular Effects of Septic Shock, G5457525012, Thiamine v placebo to improve oxygen consumption after in-hospital cardiac arrest, Thiamine as a Renal Protective Agent in Septic Shock, Harvard Clinical and Translational Science Center, G994665467

OpenAlex ID: W2899140988

FWCI: 3.037

Cites: 68

Cited by: 156

Related to: 10