Evaluation of Outcomes in Patients with Severe Sepsis and Septic Shock Treated with Intravenous Ascorbic Acid, Hydrocortisone Monroe Crawley, Mickala Thompson Huntsville Hospital - Huntsville, AL
Background/Purpose: A small, retrospective study by Marik et al, published in Chest in June 2017, demonstrated improved outcomes in patients with severe sepsis or septic shock who received intravenous ascorbic acid, hydrocortisone, and thiamine, when compared to those receiving standard therapy. Following this publication, this medication regimen became more frequently utilized in our institution_x0019_s intensive care units (ICUs) and emergency department. The purpose of this study is to evaluate the efficacy of this combination medication regimen in patients with severe sepsis and septic shock in a large community hospital.
Methodology: An Investigational Review Board approved retrospective analysis was performed in patients admitted to the ICU from January to December 2017, with a diagnosis of severe sepsis or septic shock. The study population consisted of patients receiving intravenous ascorbic acid and thiamine on days 1-4 with concomitant hydrocortisone on days 1-7 (or until ICU discharge). The study population was compared to patients receiving standard medication therapy. Average ICU length of stay, time to vasopressor discontinuation, adherence to protocol, mortality, and time to extubation (if applicable) was compared between groups.
Presentation Objective: Make recommendations regarding the continued use of intravenous ascorbic acid, hydrocortisone, and thiamine in severe sepsis/septic shock patients in a large community hospital.
Self-Assessment: What factors should be considered when evaluating the implementation of this protocol in the ICU setting?
