BACKGROUND Sepsis is a major public health burden resulting in 25-30% in-hospital mortality and accounting for over 20 billion dollars of United States hospital costs. METHODS This was a randomized, double-blinded, placebo controlled trial conducted from February 2018 to June 2019 assessing an ascorbic acid (AA), thiamine, and hydrocortisone (HAT) treatment bundle for the management of septic and septic shock patients admitted to an intensive care unit (ICU). The primary outcomes were resolution of shock and change in Sequential Organ Failure Assessment (SOFA) score. Secondary outcomes included 28-day mortality, ICU mortality, hospital mortality, procalcitonin clearance (PCT-c), hospital length of stay (LOS), ICU LOS, and ventilator free days. RESULTS 137 patients were randomized to the treatment group (n = 68) and comparator group (n = 69) respectively with no significant differences in baseline characteristics. There was a statistically significant difference in the time patients required vasopressors indicating quicker reversal of shock in the HAT group compared to comparator group (27 ± 22 vs 53 ± 38 hours, p < 0.001). There was no statistically significant change in SOFA score between groups 3 (1 - 6) vs. 2 (0 - 4), p = 0.17. There were no significant differences between study arms in ICU and hospital mortality, ICU and hospital LOS, ventilator free days, and PCT-c. CONCLUSION Our results suggest that the combination of intravenous ascorbic acid, thiamine, and hydrocortisone significantly reduced the time to resolution of shock. Additional studies are needed to confirm these findings and assess any potential mortality benefit from this treatment.

中文翻译：

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在脓毒症早期治疗中使用抗坏血酸、硫胺素和糖皮质激素进行代谢复苏的结果。

背景脓毒症是一种主要的公共健康负担，导致 25-30% 的院内死亡率并占美国医院费用超过 200 亿美元。方法 这是一项随机、双盲、安慰剂对照试验，于 2018 年 2 月至 2019 年 6 月进行，评估了抗坏血酸 (AA)、硫胺素和氢化可的松 (HAT) 联合治疗方案，用于管理接受重症监护的脓毒症和脓毒性休克患者。护理单元（ICU）。主要结果是休克的缓解和顺序器官衰竭评估 (SOFA) 评分的变化。次要结果包括 28 天死亡率、ICU 死亡率、住院死亡率、降钙素原清除率 (PCT-c)、住院时间 (LOS)、ICU LOS 和无呼吸机天数。结果 137 名患者分别随机分为治疗组（n = 68）和对照组（n = 69），基线特征无显着差异。与对照组相比，HAT 组患者需要升压药的时间有统计学意义的差异，表明休克逆转更快（27 ± 22 对 53 ± 38 小时，p < 0.001）。SOFA 评分在第 3 组 (1 - 6) 与第 2 组 (0 - 4) 之间没有统计学上的显着变化，p = 0.17。ICU 和医院死亡率、ICU 和医院 LOS、无呼吸机天数和 PCT-c 的研究组之间没有显着差异。结论 我们的结果表明，静脉注射抗坏血酸、硫胺素和氢化可的松的组合显着缩短了休克消退的时间。