Combination therapy of thiamine, vitamin C and hydrocortisone in treating patients with sepsis and septic shock: a meta-analysis and trial sequential analysis
- Burns & Trauma Vol. 9, Issue 1, (2021)
- 作者机构：
1. Translational Medicine Research Center
2. Department of Burn Surgery
3. Research Unit of key techniques for treatment of burns and combined burns and trauma injury
4. Medical Research and Biometrics Center
5. Department of Cardiothoracic Surgery
6. International Cooperation Laboratory on Signal Transduction
7. Department of Emergency
8. Department of Critical Care Medicine
9. Medical ICU
- 作者简介：
- 基金信息：
DOI：10.1093/burnst/tkab040
CLC：Published：2021，
Published Online：6 December 2021，
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Renqi Yao, Yibing Zhu, Yue Yu, Zhixuan Li, Lixue Wang, Liyu Zheng, Jingyan Li, Huibin Huang, Guosheng Wu, Feng Zhu, Zhaofan Xia, Chao Ren, Yongming Yao, Combination therapy of thiamine, vitamin C and hydrocortisone in treating patients with sepsis and septic shock: a meta-analysis and trial sequential analysis, Burns & Trauma, Volume 9, 2021, tkab040, https://doi.org/10.1093/burnst/tkab040
Renqi Yao, Yibing Zhu, Yue Yu, Zhixuan Li, Lixue Wang, Liyu Zheng, Jingyan Li, Huibin Huang, Guosheng Wu, Feng Zhu, Zhaofan Xia, Chao Ren, Yongming Yao, Combination therapy of thiamine, vitamin C and hydrocortisone in treating patients with sepsis and septic shock: a meta-analysis and trial sequential analysis, Burns & Trauma, Volume 9, 2021, tkab040, https://doi.org/10.1093/burnst/tkab040 DOI：
摘要
Abstract
BackgroundThe objective of this study was to evaluate the clinical efficacy of thiamine and vitamin C with or without hydrocortisone coadministration on the treatment of sepsis and septic shock.MethodsMEDLINE
EMBASE and CENTRAL databases were searched for randomized controlled trials (RCTs) that made a comparative study between the combination therapy of vitamin C and thiamine with or without hydrocortisone and the administration of placebo in patients with sepsis or septic shock. Two reviewers independently performed study selection
data extraction and quality assessment. Both short-term mortality and change in the sequential organ failure assessment (SOFA) score from baseline (delta SOFA) were set as the primary outcomes. Secondary endpoints included intensive care unit (ICU) mortality
new onset of acute kidney injury
total adverse events
ICU and hospital length of stay
duration of vasopressor usage and ventilator-free days. Meanwhile
trial sequential analysis was conducted for primary outcomes.ResultsEight RCTs with 1428 patients were included in the current study. The results showed no significant reduction of short-term mortality in sepsis and septic shock patients who received combination therapy of vitamin C and thiamine with or without hydrocortisone compared to those with placebo {risk ratio (RR)
1.02 [95% confidence interval (CI)
0.87 to 1.20]
p = 0.81
I2 = 0%; risk difference (RD)
0 [95% CI
−0.04 to 0.05]}. Nevertheless
the combination therapy was associated with significant reduction in SOFA score [mean difference (MD)
−0.63
(95% CI
−0.96 to −0.29
p < 0.001
I2 = 0%] and vasopressors duration (MD
−22.11 [95% CI
−30.46 to −13.77]
p < 0.001
I2 = 6%). Additionally
there were no statistical differences in the pooled estimate for other outcomes.ConclusionsIn the current meta-analysis
the combination therapy of vitamin C and thiamine
with or without hydrocortisone had no impact on short-term mortality when compared with placebo
but was associated with significant reduction in SOFA score among patients with sepsis and septic shock.
关键词
Keywords
ThiamineVitamin CSepsisSeptic shockSequential organ failure assessmentMeta-analysis
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