Vit C, Thiamine and Hydrocortisone in Sepsis : New trial needed

Paul Marik et el published a “retrospective before after ” study in Chest, Dec, 2016 about use of combination of parenteral Vit C, Thiamine and Hydrocortisone in sepsis and reported a mortality of 8.5% in treatment group compared with 40.4% in control group(p =<0.001).

Results are astonishing if you believe in the study.

There are several problems with the study.

  1. Retrospective
  2. Before after
  3. Why use combination of three ? Does combination work better than individual meds ? Is there a synergistic effect ?
  4. Single center
  5. Less number of patients
  6. Potential bias by investigators

Bottom Line

We need multi center randomized placebo controlled trial to really assess the claim.

No difference in outcomes with IV or IO in out of hospital cardiac arrest.Read more
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