Hydrocortisone, Ascorbic Acid and Thiamine (HAT Therapy) for the Treatment of Sepsis. Focus on Ascorbic Acid

Marik, Paul E.

doi:10.3390/nu10111762

Cited by 103 publications

(86 citation statements)

References 112 publications

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“…In vitro and animal studies suggest important roles for various nutrients. Recently, several investigators explored the role of vitamin c and thiamine supplementation during critical illness with particular emphasis on patients with sepsis [31][32][33][34][35] . However, the role of nutrient supplementation in patients with severe AKI has not been studied.…”

Section: Discussionmentioning

confidence: 99%

Micronutrients in critically ill patients with severe acute kidney injury – a prospective study

Ostermann

Summers

Lei

et al. 2020

Sci Rep

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Malnutrition is common in patients with acute kidney injury (AKi) and the risk of mortality is high, especially if renal replacement therapy is needed. Between April 2013 through April 2014, we recruited critically ill adult patients (≥18 years) with severe AKI in two University hospitals in London, UK, and measured serial plasma concentrations of vitamin B 1 , B 6 , B 12 , c and D, folate, selenium, zinc, copper, iron, carnitine and 22 amino acids for six consecutive days. In patients receiving continuous renal replacement therapy (CRRT), the concentrations of the same nutrients in the effluent were also determined. cRRt patients (n = 31) had lower plasma concentrations of citrulline, glutamic acid and carnitine at 24 hrs after enrolment and significantly lower plasma glutamic acid concentrations (74.4 versus 98.2 μmol/L) at day 6 compared to non-CRRT patients (n = 24). All amino acids, trace elements, vitamin C and folate were detectable in effluent fluid. In >30% of CRRT and non-CRRT patients, the plasma nutrient concentrations of zinc, iron, selenium, vitamin D 3 , vitamin c, trytophan, taurine, histidine and hydroxyproline were below the reference range throughout the 6-day period. In conclusion, altered micronutrient status is common in patients with severe AKi regardless of treatment with cRRt.

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Section: Discussionmentioning

confidence: 99%

Micronutrients in critically ill patients with severe acute kidney injury – a prospective study

Ostermann

Summers

Lei

et al. 2020

Sci Rep

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“…Recent studies have reported promising outcomes (prevention of progressive organ dysfunction and reduced mortality) of vitamin C and thiamine treatment in patients with septic shock [31,37]. However, findings on the effect of vitamin C and thiamine are still controversial [38,39].…”

Section: Discussionmentioning

confidence: 99%

Impact of Vitamin C and Thiamine Administration on Delirium-Free Days in Patients with Septic Shock

Park

Shin

et al. 2020

JCM

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Sepsis is a common cause of delirium in the intensive care unit (ICU). Recently, vitamin C and thiamine administration has been gaining interest as a potential adjunct therapy for sepsis. We investigated the impact of early vitamin C and thiamine administration on ICU delirium-free days among critically ill patients in septic shock. We performed a single-center, retrospective study of patients who visited the emergency department (ED) from January 2017 to July 2018. We categorized patients into a treatment (received vitamin C and thiamine) and control group. We compared delirium-free days within 14 days after ICU admission using propensity score matching. Of 435 patients with septic shock, we assigned 89 propensity score-matched pairs to the treatment and control groups. The median delirium-free days did not differ between treatment (11, interquartile range [IQR] 5–14 days) and control (12, IQR 6–14 days) groups (p = 0.894). Secondary outcomes were not different between the two groups, including delirium incidence and 28-day mortality. These findings were consistent after subgroup analysis for patients who met the sepsis-3 definition of septic shock. Vitamin C and thiamine administration showed no association with ICU delirium-free days among patients in septic shock.

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“…Vitamin C is an effective intracellular antioxidant for biomolecules and has significant ROS scavenging activity that results in the inhibition of the inflammatory NF-κβ signal transduction pathway (56). In addition, the phagocytic activity of neutrophils and macrophages is regulated by their vitamin C content (106). Supplemental vitamin C may decrease the severity of obesity and its comorbidities by regulating lipid accumulation, inhibiting lipolysis that reduces systematic FFA efflux, and glucocorticoid production, reducing ROS activity and interfering adipocyte macrophages, thus decrease pro-inflammatory adipokines (leptin) and cytokines (107).…”

Section: Vitamin Cmentioning

confidence: 99%

Clinical Impact Potential of Supplemental Nutrients as Adjuncts of Therapy in High-Risk COVID-19 for Obese Patients

Şahin

Orhan

Uckun³

et al. 2020

Front. Nutr.

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The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease (COVID-19) in China at the end of 2019 caused a major global pandemic and continues to be an unresolved global health crisis. The supportive care interventions for reducing the severity of symptoms along with participation in clinical trials of investigational treatments are the mainstay of COVID-19 management because there is no effective standard therapy for COVID-19. The comorbidity of COVID-19 rises in obese patients. Micronutrients may boost the host immunity against viral infections, including COVID-19. In this review, we discuss the clinical impact potential of supplemental nutrients as adjuncts of therapy in high-risk COVID-19 for obese patients.

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Hydrocortisone, Ascorbic Acid and Thiamine (HAT Therapy) for the Treatment of Sepsis. Focus on Ascorbic Acid

Cited by 103 publications

References 112 publications

Micronutrients in critically ill patients with severe acute kidney injury – a prospective study

Micronutrients in critically ill patients with severe acute kidney injury – a prospective study

Impact of Vitamin C and Thiamine Administration on Delirium-Free Days in Patients with Septic Shock

Clinical Impact Potential of Supplemental Nutrients as Adjuncts of Therapy in High-Risk COVID-19 for Obese Patients

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