No benefit of hydrocortisone,ascorbic acid,and thiamine in reducing mortality in adult sepsis patients:a systematic review and meta-analysis  

作　　者：Qing Zhao Jianguo Xiao Hui Liu 

机构地区：[1]Department of Diagnosis and Treatment of Cadres,1st Medical Center,Chinese PLA General Hospital,Beijing,China [2]CCM Department,1st Medical Center,Chinese PLA General Hospital,Beijing,China

出　　处：《Emergency and Critical Care Medicine》2022年第3期167-174,共8页急危重症医学（英文）

摘　　要：Background:Supplementation of corticosteroid,ascorbic acid and thiamine in adult septic patients remains controversial.We aimed to evaluate the efficacy and safety of hydrocortisone,ascorbic acid and thiamine(HAT)in adult septic patients.Methods:Data search included Pumbed,EMBASE,and the Cochrane Library from inception to Sep,2021.Only studies with classifications of sepsis and intravenous HAT treatment were included.Adult patients with sepsis(aged≥18 years)were divided into 2 groups.The treatment group received HAT therapy,whereas the control group received standard care and/or intravenous hydrocortisone.The primary outcome was hospital mortality.Results:Eleven studies including 4579 patients who fulfilled the predefined criteria were analyzed(6 randomized controlled trials[RCTs]and 5 clinical cohort studies).No hospital mortality reduction was demonstrated in patients treated with HAT when compared to the reference(OR:0.99;95%CI:0.77 to 1.27;I^(2)=39%)group.Sequential organ failure assessment(SOFA)score decrement at 72hours was more significant in HAT-treated patients(mean difference[MD]:–1.23;95%CI:–1.94 to–0.53;I^(2)=81%).There was no difference in the duration of vasopressor use between HAT-treated patients and controls(MD:–4.92;95%CI:–24.38 to 14.53;I^(2)=97%).Statistical heterogeneity was noted with no sign of significant publication bias.Conclusion:In adult sepsis and septic shock patients,HAT treatment failed to reduce mortality or shorten vasopressor duration,but reduced SOFA scores.

关 键 词：Ascorbic acid CORTICOSTEROID META-ANALYSIS SEPSIS THIAMINE 

分 类 号：R515.3[医药卫生—内科学]