Early administration of hydrocortisone, vitamin C, and thiamine in adult patients with septic shock: a randomized controlled clinical trial

Study answer

What this study found

Early hydrocortisone, vitamin C, and thiamine did not improve survival or key clinical recovery outcomes in adult septic shock. Ninety-day mortality was 40.4% (86/213) with the intervention versus 39.0% (83/213) with placebo in ITT analysis (HR 1.08; 95% CI 0.80-1.46; P = 0.62), with similar null findings in PP analysis. There were also no meaningful differences in 28-day, ICU, or hospital mortality, shock reversal, time to shock reversal, or ICU-free days. Blood glucose disturbance was more common with the intervention (12.7% [27/213] vs 0.0%; P < 0.001).

Study & population

Randomized, placebo-controlled clinical trial in adults with septic shock diagnosed within 12 hours and treated in a single ICU at Northern Jiangsu People's Hospital in Yangzhou, China.

Intervention

The active regimen combined hydrocortisone 200 mg daily by continuous intravenous infusion over 24 h, vitamin C 2 g every 6 h, and thiamine 200 mg every 12 h.

Key limitation

Single-center trial in a Chinese Han ICU population, which limits generalizability.

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Original abstract