No benefit of hydrocortisone, ascorbic acid, and thiamine in reducing mortality in adult sepsis patients: a systematic review and meta-analysis
Abstract. Background. Supplementation of corticosteroid, ascorbic acid and thiamine in adult septic patients remains controversial. We aimed to evaluate the efficacy and safety of hydrocortisone, ascorbic acid and thiamine (HAT) in adult septic patients. Methods. Data search included Pumbed, EMBASE,...
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Wolters Kluwer Health/LWW
2022-09-01
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| Series: | Emergency and Critical Care Medicine |
| Online Access: | http://journals.lww.com/10.1097/EC9.0000000000000036 |
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| author | Qing Zhao Jianguo Xiao Hui Liu |
| author_facet | Qing Zhao Jianguo Xiao Hui Liu |
| author_sort | Qing Zhao |
| collection | DOAJ |
| description | Abstract. Background. Supplementation of corticosteroid, ascorbic acid and thiamine in adult septic patients remains controversial. We aimed to evaluate the efficacy and safety of hydrocortisone, ascorbic acid and thiamine (HAT) in adult septic patients.
Methods. Data search included Pumbed, EMBASE, and the Cochrane Library from inception to Sep, 2021. Only studies with classifications of sepsis and intravenous HAT treatment were included. Adult patients with sepsis (aged ≥18 years) were divided into 2 groups. The treatment group received HAT therapy, whereas the control group received standard care and/or intravenous hydrocortisone. The primary outcome was hospital mortality.
Results. Eleven studies including 4579 patients who fulfilled the predefined criteria were analyzed (6 randomized controlled trials [RCTs] and 5 clinical cohort studies). No hospital mortality reduction was demonstrated in patients treated with HAT when compared to the reference (OR: 0.99; 95% CI: 0.77 to 1.27; I2 = 39%) group. Sequential organ failure assessment (SOFA) score decrement at 72hours was more significant in HAT-treated patients (mean difference [MD]: –1.23; 95% CI: –1.94 to –0.53; I2 = 81%). There was no difference in the duration of vasopressor use between HAT-treated patients and controls (MD: –4.92; 95% CI: –24.38 to 14.53; I2 = 97%). Statistical heterogeneity was noted with no sign of significant publication bias.
Conclusion. In adult sepsis and septic shock patients, HAT treatment failed to reduce mortality or shorten vasopressor duration, but reduced SOFA scores. |
| format | Article |
| id | doaj-art-1350ea2d01e74955b641f99c67a12766 |
| institution | OA Journals |
| issn | 2097-0617 2693-860X |
| language | English |
| publishDate | 2022-09-01 |
| publisher | Wolters Kluwer Health/LWW |
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| series | Emergency and Critical Care Medicine |
| spelling | doaj-art-1350ea2d01e74955b641f99c67a127662025-08-20T01:54:12ZengWolters Kluwer Health/LWWEmergency and Critical Care Medicine2097-06172693-860X2022-09-012316717410.1097/EC9.0000000000000036202209000-00009No benefit of hydrocortisone, ascorbic acid, and thiamine in reducing mortality in adult sepsis patients: a systematic review and meta-analysisQing Zhao0Jianguo Xiao1Hui Liu2a Department of Diagnosis and Treatment of Cadres, 1st Medical Center, Chinese PLA General Hospital, Beijing, Chinab CCM Department, 1st Medical Center, Chinese PLA General Hospital, Beijing, China.b CCM Department, 1st Medical Center, Chinese PLA General Hospital, Beijing, China.Abstract. Background. Supplementation of corticosteroid, ascorbic acid and thiamine in adult septic patients remains controversial. We aimed to evaluate the efficacy and safety of hydrocortisone, ascorbic acid and thiamine (HAT) in adult septic patients. Methods. Data search included Pumbed, EMBASE, and the Cochrane Library from inception to Sep, 2021. Only studies with classifications of sepsis and intravenous HAT treatment were included. Adult patients with sepsis (aged ≥18 years) were divided into 2 groups. The treatment group received HAT therapy, whereas the control group received standard care and/or intravenous hydrocortisone. The primary outcome was hospital mortality. Results. Eleven studies including 4579 patients who fulfilled the predefined criteria were analyzed (6 randomized controlled trials [RCTs] and 5 clinical cohort studies). No hospital mortality reduction was demonstrated in patients treated with HAT when compared to the reference (OR: 0.99; 95% CI: 0.77 to 1.27; I2 = 39%) group. Sequential organ failure assessment (SOFA) score decrement at 72hours was more significant in HAT-treated patients (mean difference [MD]: –1.23; 95% CI: –1.94 to –0.53; I2 = 81%). There was no difference in the duration of vasopressor use between HAT-treated patients and controls (MD: –4.92; 95% CI: –24.38 to 14.53; I2 = 97%). Statistical heterogeneity was noted with no sign of significant publication bias. Conclusion. In adult sepsis and septic shock patients, HAT treatment failed to reduce mortality or shorten vasopressor duration, but reduced SOFA scores.http://journals.lww.com/10.1097/EC9.0000000000000036 |
| spellingShingle | Qing Zhao Jianguo Xiao Hui Liu No benefit of hydrocortisone, ascorbic acid, and thiamine in reducing mortality in adult sepsis patients: a systematic review and meta-analysis Emergency and Critical Care Medicine |
| title | No benefit of hydrocortisone, ascorbic acid, and thiamine in reducing mortality in adult sepsis patients: a systematic review and meta-analysis |
| title_full | No benefit of hydrocortisone, ascorbic acid, and thiamine in reducing mortality in adult sepsis patients: a systematic review and meta-analysis |
| title_fullStr | No benefit of hydrocortisone, ascorbic acid, and thiamine in reducing mortality in adult sepsis patients: a systematic review and meta-analysis |
| title_full_unstemmed | No benefit of hydrocortisone, ascorbic acid, and thiamine in reducing mortality in adult sepsis patients: a systematic review and meta-analysis |
| title_short | No benefit of hydrocortisone, ascorbic acid, and thiamine in reducing mortality in adult sepsis patients: a systematic review and meta-analysis |
| title_sort | no benefit of hydrocortisone ascorbic acid and thiamine in reducing mortality in adult sepsis patients a systematic review and meta analysis |
| url | http://journals.lww.com/10.1097/EC9.0000000000000036 |
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