6/28/23, 12:46 AM ATESS Pathway Feedback Search Clinical Topics Home Studies ATESS ATESS Disease Sepsis and septic shock Trial question What is the effect of combination therapy of vitamin C and thiamine in patients with septic shock? Study design Multi-center Double blinded RCT Population Characteristics of study participants 60.0% female N = 111 40.0% male 111 patients (67 female, 44 male) Inclusion criteria: adult patients with septic shock Key exclusion criteria: transfer from another hospital with vasopressor administration or mechanical ventilator support, an underlying terminal-stage disease, taking at least 1 g/day of vitamin C or receiving intravenous thiamine prior to enrolment, cardiac arrest prior to enrolment, renal or ureteral stones Interventions N=53 vitamin C and thiamine (intravenous vitamin C 50 mg/kg, maximum single dose 3 g and thiamine 200 mg administration every 12 h for a total of 48 h) N=58 placebo (identical volume of 0.9% saline with the same protocol) https://web.pathway.md/studies/recQ6cdaagAQc4sgB 1/2 6/28/23, 12:46 AM ATESS Pathway Primary outcome Death at 28 days 20.8 % 20.8 15.6 % 15.5 10.4 % 5.2 % No significant difference 0.0 % Vitamin C and thiamine Placebo No significant difference in death at 28 days (20.8% vs. 15.5%; AD 5.2%, 95% CI -9.1 to 19.6) Secondary outcomes No significant difference in shock reversal (83% vs. 84.5%; ARD -1.5, 95% CI -15.2 to 12.3) Safety outcomes No significant differences in ventilator-free days, new-onset AKI, ICU-free days, reduction of procalcitonin. Significant difference in adverse events (0% vs. 3.5%). Conclusion In adult patients with septic shock, vitamin C and thiamine were not superior to placebo with respect to death at 28 days. Reference Sung Yeon Hwang, Seung Mok Ryoo, Jong Eun Park et al. Combination therapy of vitamin C and thiamine for septic shock: a multi-centre, double-blinded randomized, controlled study. Intensive Care Med. 2020 Nov;46(11):2015-2025. Open reference URL https://web.pathway.md/studies/recQ6cdaagAQc4sgB 2/2