Vitamin C, Thiamine and Hydrocortisone for the Treatment of Septic Shock

Initiation of Vitamin C, Thiamine and Hydrocortisone Therapy for Septic Shock in Adults: A Randomized Clinical Trial

The purpose of this study is to determine whether the combination therapy (vitamin C,thiamine and hydrocortisone) is effective in the treatment of septic shock.

Septic Shock is a leading cause of morbidity and mortality in critically ill patients worldwide.

A potential benefit of vitamin C with thiamine and low-dose hydrocortisone in the treatment of septic shock has recently been described(PMID 27940189) . The patients with septic shock who received this combination of medications weaned off pressors earlier, suffered less organ failure, and had improved mortality. The doses of vitamin C used in this trial are high, yet seemed to be safe and can be considered for use.

In this randomized controlled trial, we aim to evaluate the effect of the combination therapy (vitamin C,thiamine and hydrocortisone) on septic shock.

Inclusion Criteria:

• Age 18 years old or older
• Onset of septic shock within 12 hours

Exclusion Criteria:

• Systemic corticosteroid therapy within the last 3 months before septic shock
• High-dose steroid therapy
• Immunosuppression
• Pregnant
• Known glucose-6 phosphate dehydrogenase (G-6PD) deficiency
• Known hemachromatosis
• Known allergy to vitamin C, hydrocortisone, or thiamine
• Anticipated death from a preexisting disease within 90 days after randomization (as determined by the enrolling physician)
• Refusal of the attending staff or patient family