Evidence map›Paper›PMID 32939746›Full record

Observational studyCanadian journal of anaesthesia = Journal canadien d'anesthesie2020

Adding vitamin C to hydrocortisone lacks benefit in septic shock: a historical cohort study.

Kimberley Chang, Megan Harbin, Constantin Shuster, Donald E G Griesdale, Denise Foster, David Sweet, Michael D Wood, Vinay K Dhingra

Open access · bronzeAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Canadian journal of anaesthesia = Journal canadien d'anesthesie, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
0.6field-weighted citation impact, top 34% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Kimberley ChangFaculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
Megan HarbinDepartment of Pharmaceutical Sciences, Vancouver General Hospital, and Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada.
Constantin ShusterDivision of Critical Care Medicine, Vancouver General Hospital, University of British Columbia, Vancouver, BC, Canada.
Donald E G GriesdaleCentre for Clinical Epidemiology & Evaluation, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada.
Denise FosterDepartment of Medicine, Vancouver General Hospital, University of British Columbia, Vancouver, BC, Canada.
David SweetDivision of Critical Care Medicine, Vancouver General Hospital, University of British Columbia, Vancouver, BC, Canada.
Michael D WoodDepartment of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, BC, Canada.
Vinay K DhingraDivision of Critical Care Medicine, Vancouver General Hospital, University of British Columbia, Vancouver, BC, Canada. Vinay.dhingra@vch.ca.
University of British Columbia · CAVancouver General Hospital · CAVancouver Coastal Health Research Institute · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeSepsis has high incidence and mortality rates, particularly in the intensive care unit (ICU). Corticosteroids may improve outcomes, and vitamin C may add benefit. We aimed to assess whether vitamin C and corticosteroids improved outcomes compared with corticosteroids alone.

methodsThis historical cohort study (11 December 2016 to 21 February 2018) was conducted in the ICU of a quaternary referral hospital. Patients with an ICU admission diagnosis of sepsis or septic shock who received vitamin C and hydrocortisone within 72 hr were compared with those who received only hydrocortisone. All patients received standard sepsis care including source control, antibiotics, and fluid resuscitation. Most patients received thiamine as standard ICU care. The primary outcome was hospital mortality. Secondary outcomes included ICU mortality, ventilator-free days, vasopressor-free days, dialysis use, and duration of ICU admission.

resultsOne hundred and forty-four patients were included in the study. The mean (standard deviation [SD]) age was 64 (15) yr; 39% were female; and the mean (SD) Acute Physiology And Chronic Health Evaluation IV score was 89 (30). Eighty-eight patients did not receive vitamin C and 52 received vitamin C. There was no observed difference in hospital mortality between the non-vitamin C (36%) and vitamin C (39%) groups (adjusted odds ratio for hospital death, 0.52; 95% confidence interval, 0.20 to 1.34; P = 0.18). There were no statistically significant differences in any secondary outcomes.

conclusionIn this small observational study of ICU patients with septic shock, the addition of vitamin C to hydrocortisone therapy did significantly affect hospital mortality or other measures of mortality or organ dysfunction.

Indexed as

SepsisShock, SepticAscorbic AcidCohort StudiesFemaleHospital MortalityHumansHydrocortisoneIntensive Care UnitsMaleVitaminsAscorbic AcidHydrocortisoneVitaminscorticosteroidscritical careICUseptic shockvitamin C

Identifiers

PMID32939746
PMCPMC7493833
OpenAlexW3086103814

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.