ArticleIndian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine2020
Metabolic Resuscitation Using Hydrocortisone, Ascorbic Acid, and Thiamine: Do Individual Components Influence Reversal of Shock Independently?
Article in Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 4 of them syntheses that pooled it.
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Who cites it
9 citing papers in PubMed, 4 syntheses or guidelines pooled it, 20 citations in OpenAlex.
- Therapeutic Role of HAT Therapy in Sepsis: A Systematic Review and Meta-Analysis.Current medicinal chemistry · 2025Pooled it
- Association of Oral or Intravenous Vitamin C Supplementation with Mortality: A Systematic Review and Meta-Analysis.Nutrients · 2023Pooled 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
- The Japanese Critical Care Nutrition Guideline 2024.Journal of intensive care · 2025Review
- Evaluation of the Effects of a Combination of Vitamin C, Thiamine and Hydrocortisone vs Hydrocortisone Alone on ICU Outcome in Patients with Septic Shock: A Randomized Controlled Trial.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2024Article
- Differential effects of thiamine and ascorbic acid in clusters of septic patients identified by latent variable analysis.Critical care (London, England) · 2024Article
- Hydrocortisone, ascorbic acid, and thiamine (HAT) for sepsis and septic shock: a meta-analysis with sequential trial analysis.Journal of intensive care · 2021Article
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Authors and funding
5 authors.
Funding
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Abstract
AIMS AND
objectiveTo study the effects of various components of "metabolic resuscitation" on the shock reversal among patients with septic shock.
introductionSepsis is characterized by dysregulated host response to infection. Mitochondrial dysfunction which occurs early in sepsis is associated with multiorgan dysfunction. Therapies such as adequate resuscitation, early administration of antibiotics, and aggressive monitoring reduced mortality substantially but it still remains high for those with septic shock. Combination of vitamin C, hydrocortisone, and thiamine improved outcome in a retrospective study, but how effective is this therapy in isolation compared to combination has to be known before implementation. MATERIALS AND
methodsThis study is single-center, prospective, randomized nonblinded trial done in septic shock patients admitted to the medical intensive care unit. Subjects were randomized to three groups of hydrocortisone (H), hydrocortisone, ascorbic acid (HA), hydrocortisone, ascorbic acid, thiamine (HAT). Following randomization, they received hydrocortisone 200 mg over 24 hours as infusion, intravenous ascorbic acid 1.5 g every 6 hours, thiamine 200 mg twice daily as allotted and continued till shock reversal or death. Primary outcome is time to shock reversal and secondary outcome is time to vasopressor dose reduction from hemodynamic SOFA score 4-3.
resultsTwenty seven subjects were randomized into 3 groups of 9 each, of which 17 (63%) patients met primary outcome and secondary outcome has been studied in 16 (59%) patients. Eight patients (29.5%) died and did not meet either outcome and two patients (7.5%) met secondary outcome but not primary outcome because of discharge to other hospital. There is no difference in time to shock reversal [mean, SD in H (7422, 8348), HA (2528, 3086), HAT (1860, 749),
conclusionIn patients with septic shock, there is no difference in time to shock reversal comparing individual components of metabolic resuscitation. HOW TO CITE THIS ARTICLE: Reddy PR, Samavedam S, Aluru N, Yelle S, Rajyalakshmi B. Metabolic Resuscitation Using Hydrocortisone, Ascorbic Acid, and Thiamine: Do Individual Components Influence Reversal of Shock Independently? Indian J Crit Care Med 2020;24(8):649-652.
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