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The Efficacy of vitamin C, thiamine, and corticosteroid therapy in adult sepsis patients: a systematic review and meta-analysis

机译：维生素C，硫胺素和皮质类固醇治疗成人败血症患者的疗效：系统审查和荟萃分析

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Background:Previous studies have suggested favorable outcomes of hydrocortisone, ascorbic acid (vitamin C), and thiamine (HAT) therapy in patients with sepsis. However, similar results have not been duplicated in sequential studies. This meta-analysis aimed to reevaluate the value of HAT treatment in patients with sepsis.Methods:Electronic databases were searched up until October 2020 for any studies that compared the effect of HAT versus non-HAT use in patients with sepsis.Results:Data from 15 studies (eight randomized controlled trials [RCTs] and seven cohort studies) involving 67,349 patients were included. The results from the RCTs show no significant benefit of triple therapy on hospital mortality (risk ratio [RR], 0.99; P=0.92; I2=0%); intensive care unit (ICU) mortality (RR, 0.77; P=0.20; I2=58%); ICU length of stay (weighted mean difference [WMD], 0.11; P=0.86; I2=37%) or hospital length of stay (WMD: 0.57; P=0.49; I2=17%), and renal replacement therapy (RR, 0.64; P=0.44; I2=39%). The delta Sequential Organ Failure Assessment (SOFA) score favored treatment after a sensitivity analysis (WMD, -0.72; P=0.01; I2=32%). However, a significant effect was noted for the duration of vasopressor use (WMD, -25.49; P0.001; I2=46%). The results from cohort studies have also shown no significant benefit of HAT therapy on hospital mortality, ICU mortality, ICU length of stay, length of hospital stay, the delta SOFA score, the use of renal replacement therapy, or vasopressor duration.Conclusion:HAT therapy significantly reduced the duration of vasopressor use and improved the SOFA score but appeared not to have significant benefits in other outcomes for patients with sepsis. Further RCTs can help understand its benefit exclusively.
机译：背景：以前的研究表明患有败血症患者的氢化胞嘧啶，抗坏血酸（维生素C）和硫胺素（帽子）治疗的有利结果。然而，在连续研究中尚未重复类似的结果。这种META分析旨在重新评估患有SEPSIS患者帽子治疗的价值15涉及涉及67,349名患者的涉及67,349名患者的八项随机对照试验[RCTS]和七个群组研究）。 RCT的结果显示出对医院死亡率的三重治疗（风险比[RR]，0.99; P = 0.92; I2 = 0％）的显着益处;重症监护单元（ICU）死亡率（RR，0.77; P = 0.20; I2 = 58％）; ICU保持长度（加权平均差异[WMD]，0.11; P = 0.86; I2 = 37％）或医院住院时间（WMD：0.57; P = 0.49; I2 = 17％）和肾置换疗法（RR， 0.64; p = 0.44; I2 = 39％）。 δ顺序器官失效评估（沙发）得分受到敏感性分析后的处理（WMD，-0.72; P = 0.01; I2 = 32％）。然而，在血管加压器使用的持续时间（WMD，-25.49; P <0.001; I2 = 46％），注意到显着效果。队列研究的结果也显示出对医院死亡率，ICU死亡率，ICU的逗留时间，住院时间长度，临时沙发评分，肾脏替代疗法的使用，或血管加压器持续时间的明显效益。或血管加压器持续时间。结论：帽子疗法显着降低了血管加压器使用的持续时间，并改善了沙发评分，但出现在败血症患者的其他结果中没有显着益处。进一步的RCT可以帮助理解其利益。

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