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首页> 美国卫生研究院文献>Journal of Clinical Medicine >Vitamin C Hydrocortisone and Thiamine for the Treatment of Severe Sepsis and Septic Shock: A Retrospective Analysis of Real-World Application
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Vitamin C Hydrocortisone and Thiamine for the Treatment of Severe Sepsis and Septic Shock: A Retrospective Analysis of Real-World Application

机译：维生素C氢化可的松和硫胺素治疗严重脓毒症和败血症性休克的真实应用回顾性分析

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A recent study suggested mortality benefits using vitamin C, hydrocortisone, and thiamine combination therapy (triple therapy) in addition to standard care in patients with severe sepsis and septic shock. In order to further evaluate the effects of triple therapy in real-world clinical practice, we conducted a retrospective observational cohort study at an academic tertiary care hospital. A total of 94 patients (47 in triple therapy group and 47 in standard care group) were included in the analysis. Baseline characteristics in both groups were well-matched. No significant difference in the primary outcome, hospital mortality, was seen between triple therapy and standard care groups (40.4% vs. 40.4%; p = 1.000). In addition, there were no significant differences in secondary outcomes, including intensive care unit (ICU) mortality, requirement for renal replacement therapy for acute kidney injury, ICU length of stay, hospital length of stay, and time to vasopressor independence. When compared to standard care, triple therapy did not improve hospital or ICU mortality in patients with septic shock. A randomized controlled trial evaluating the effects of triple therapy is necessary prior to implementing vitamin C, hydrocortisone, and thiamine combination therapy as a standard of care in patients with septic shock.
机译：最近的一项研究表明，对于患有严重脓毒症和脓毒性休克的患者，除了标准治疗外，还使用维生素C，氢化可的松和硫胺素联合疗法（三联疗法）可提高死亡率。为了进一步评估三联疗法在现实世界中的临床实践效果，我们在一家三级学术医院进行了一项回顾性观察队列研究。分析共纳入94例患者（三联疗法组47例，标准护理组47例）。两组的基线特征均匹配良好。三联疗法和标准护理组之间的主要结局，医院死亡率没有显着差异（40.4％对40.4％； p = 1.000）。此外，次要结局无显着差异，包括重症监护病房（ICU）死亡率，急性肾脏损伤的肾脏替代治疗要求，ICU住院时间，住院时间以及升压药独立时间。与标准护理相比，三联疗法并不能改善败血性休克患者的医院或ICU死亡率。在感染性休克患者实施维生素C，氢化可的松和硫胺素联合治疗作为标准治疗之前，必须进行一项评估三联疗法效果的随机对照试验。

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