Trial reportIntensive care medicine2020
Combination therapy of vitamin C and thiamine for septic shock: a multi-centre, double-blinded randomized, controlled study.
Trial report in Intensive care medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 72 papers, 11 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
72 citing papers in PubMed, 11 syntheses or guidelines pooled it, 156 citations in OpenAlex.
- Effects of different vitamins on individuals with septic shock: a Bayesian NMA of RCTs.Frontiers in nutrition · 2025Pooled it
- Therapeutic Role of HAT Therapy in Sepsis: A Systematic Review and Meta-Analysis.Current medicinal chemistry · 2025Pooled it
- Mortality among adult patients with sepsis and septic shock in Korea: a systematic review and meta-analysis.Clinical and experimental emergency medicine · 2023Pooled it
- The outcome of IV vitamin C therapy in patients with sepsis or septic shock: a meta-analysis of randomized controlled trials.Critical care (London, England) · 2023Pooled it
- Effect of intravenous vitamin C on adult septic patients: a systematic review and meta-analysis.Frontiers in nutrition · 2023Pooled it
- IV Vitamin C in Sepsis: A Latest Systematic Review and Meta-Analysis.International journal of clinical practice · 2023Pooled it
- The Role and Efficacy of Vitamin C in Sepsis: A Systematic Review and Meta-Analysis.Advances in respiratory medicine · 2022Pooled it
- Effect of adjunctive vitamin C, glucocorticoids, and vitamin B1 on longer-term mortality in adults with sepsis or septic shock: a systematic review and a component network meta-analysis.Intensive care medicine · 2022Pooled it
- Vitamin C in Critically Ill Patients: An Updated Systematic Review and Meta-Analysis.Nutrients · 2021Pooled it
- Steroid, ascorbic acid, and thiamine in adults with sepsis and septic shock: a systematic review and component network meta-analysis.Scientific reports · 2021Pooled it
- Mortality in septic patients treated with vitamin C: a systematic meta-analysis.Critical care (London, England) · 2021Pooled it
- Early administration of vitamin C in patients with sepsis or septic shock in emergency departments: a multicenter, double-blind, randomized controlled trial: the C-EASIE trial.Critical care (London, England) · 2025Trial
- Effect of high-dose intravenous ascorbic acid on microcirculation and endothelial glycocalyx during sepsis and septic shock: a double-blind, randomized, placebo-controlled study.BMC anesthesiology · 2023Trial
- Trial
- Early administration of hydrocortisone, vitamin C, and thiamine in adult patients with septic shock: a randomized controlled clinical trial.Critical care (London, England) · 2022Trial
- Evaluating Vitamin C in Septic Shock: A Randomized Controlled Trial of Vitamin C Monotherapy.Critical care medicine · 2022Trial
- Effects of thiamine on vasopressor requirements in patients with septic shock: a prospective randomized controlled trial.BMC anesthesiology · 2020Trial
- Steroid, thiamine, and ascorbic acid for comatose out-of-hospital cardiac arrest survivors (STAR): a randomised, placebo-controlled, phase 2 trial.EClinicalMedicine · 2026Article
- High-Dose Intravenous Vitamin C in Critical Illness: A Translational Exposure-Response Framework for Biomarker-Guided Precision Therapy.Medical sciences (Basel, Switzerland) · 2026Review
- An in-vitro study to characterise analytical interference caused by sodium ascorbate with point-of-care measurement of lactate and glucose.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2026Article
12 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
16 authors at 6 institutions in 1 country.
Funding
Abstract
purposeTo evaluate the effects of early combination therapy with intravenous vitamin C and thiamine on recovery from organ failure in patients with septic shock.
methodsThe ascorbic acid and thiamine effect in septic shock (ATESS) trial was a multi-centre, double-blind, randomized, controlled trial conducted in four academic emergency departments, enrolling adult patients with septic shock from December 2018 through January 2020. Patients were randomly assigned in a 1:1 ratio to either the treatment group [intravenous vitamin C (50 mg/kg, maximum single dose 3 g) and thiamine (200 mg) administration every 12 h for a total of 48 h] or the placebo group (identical volume of 0.9% saline with the same protocol). The primary outcome was Δ Sequential Organ Failure Assessment (SOFA) score (SOFA score at enrolment-SOFA score after 72 h). Eighteen secondary outcomes were predefined, including shock reversal and 28-day mortality.
resultsA total of 111 patients were enrolled, of which 53 were assigned to the treatment group and 58 were assigned to the placebo group. There was no significant difference in ΔSOFA scores between the treatment group and the placebo group [3, interquartile range (IQR) - 1 to 5 vs. 3, IQR 0-4, respectively, p = 0.96]. Predefined secondary outcomes were also not significantly different between the groups.
conclusionIn this study, vitamin C and thiamine administration in the early phase of septic shock did not improve organ function compared with placebo, despite improvements in vitamin C and thiamine levels.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.