Vitamin C und Thiamin im Septischen Schock

• Verfasst von: Dietrich, Maximilian [VerfasserIn]
• Verfasst von: Märtens, Malte [VerfasserIn]
• Verfasst von: Forst, Maik von der [VerfasserIn]
• Verfasst von: Bruckner, Thomas [VerfasserIn]
• Verfasst von: Uhle, Florian [VerfasserIn]
• Verfasst von: Fiedler-Kalenka, Mascha [VerfasserIn]
• Verfasst von: Weiterer, Sebastian [VerfasserIn]
• Verfasst von: Hackert, Thilo [VerfasserIn]
• Verfasst von: Brenner, Thorsten [VerfasserIn]
• Verfasst von: Weigand, Markus A. [VerfasserIn]
• Titel: Vitamin C und Thiamin im Septischen Schock
• Titelzusatz: eine retrospektive Vorher-Nachher-Studie an chirurgischen Patienten
• Paralleltitel: Vitamin C and thiamine in septic shock
• Paralleltitelzusatz: a retrospective before-and-after study on surgical patients
• Verf.angabe: M. Dietrich, M. Martens, M. von der Forst, T. Bruckner, F. Uhle, M. Fiedler, S. Weiterer, T. Hackert, T. Brenner, M.A. Weigand
• E-Jahr: 2021
• Jahr: Februar 2021
• Umfang: 7 S.
• Fussnoten: Gesehen am 20.05.2021
• Titel Quelle: Enthalten in: Anästhesiologie & Intensivmedizin
• Ort Quelle: Ebelsbach : Aktiv Dr. und Verl., 1978
• Jahr Quelle: 2021
• Band/Heft Quelle: 62(2021) vom: Feb., Seite 63-69
• ISSN Quelle: 1439-0256
• DOI: doi:10.19224/ai2021.063
• Datenträger: Online-Ressource
• Sprache: ger
• Sach-SW: Intensive Care
• Sach-SW: Sepsis
• Sach-SW: Shock
• Sach-SW: Thiamine
• Sach-SW: Vitamin C
• K10plus-PPN: 1758213582

Abstract

Background: The administration of vitamin C and thiamine in septic shock is an innovative therapeutic approach. This study investigated the effect of vitamin C and thiamine in a surgical patient cohort with a predominantly abdominal focus. Methods: Clinical care data of septic shock patients between November 2017 and December 2019 were analysed retrospectively. All patients received sepsis therapy including hydrocortisone. The adjunctive therapy with 1.5 g vitamin C every 6 hours and 200 mg thiamine every 12 hours over 4 days was introduced in January 2019. The control group consisted of patients treated before the introduction of adjunctive therapy. Primary endpoints were in-hospital and 28-day mortality. Secondary endpoints were the duration of the patients' intensive care and invasive ventilation as well as SOFA score, C-reactive protein (CRP), serum creatinine, procalcitonin and leukocytes. Results: Both groups included 61 patients. The abdomen was the most frequent infection site (80 %). 22 patients (36.1 %) of the vitamin group and 27 patients (44.3 %) of the control group had died after 28 days (p = 0.356). In-hospital mortality of the vitamin group was 41.0 %, compared with 54.0% in the control group (p = 0.147). The duration of mechanical ventilation (6 days vs. 10 days, p = 0.029) was significantly shorter in the vitamin group. There were no significant differences in creatinine or the need for renal replacement therapy. Conclusion: High-dose vitamin C and thiamine in septic shock did not significantly reduce 28-day or in-hospital mortality in this analysis. However, a shorter duration of mechanical ventilation without an increased rate of renal complications was observed.