Elsevier

Journal of Critical Care

Volume 47, October 2018, Pages 211-218
Journal of Critical Care

Sepsis/Infection
Combined vitamin C, hydrocortisone, and thiamine therapy for patients with severe pneumonia who were admitted to the intensive care unit: Propensity score-based analysis of a before-after cohort study

https://doi.org/10.1016/j.jcrc.2018.07.004Get rights and content
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Highlights

  • The vitamin C protocol was evaluated in patients with severe pneumonia.

  • Hospital mortality tended to drop in the treatment group.

  • The chest radiologic findings were significantly improved in the treatment group.

  • This improvement associated independently with less hospital mortality.

  • The treatment did not increase acute kidney injury or superinfection.

Abstract

Purpose

To evaluate the efficacy of combined vitamin C, hydrocortisone, and thiamine in patients with severe pneumonia.

Materials and methods

All consecutive patients with severe pneumonia who were treated with the vitamin C protocol (6 g of vitamin C per day) in June 2017–January 2018 (n = 53) were compared to all consecutive patients with severe pneumonia who were treated in June 2016–January 2017 (n = 46). Propensity score analysis was used to adjust for potential baseline differences between the groups.

Results

In the propensity-matched cohort (n = 36/group), the treated patients had significantly less hospital mortality than the control group (17% vs. 39%; P = 0.04). The vitamin C protocol associated independently with decreased mortality in propensity score-adjusted analysis (adjusted odds ratio = 0.15, 95% confidence interval = 0.04–0.56, P = 0.005). Relative to the control group, the treatment group had a significantly higher median improvement in the radiologic score at day 7 compared with baseline (4 vs. 2; P = 0.045). The vitamin C protocol did not increase the rates of acute kidney injury or superinfection.

Conclusions

Combined vitamin C, hydrocortisone, and thiamine therapy may benefit patients with severe pneumonia.

Keywords

Ascorbic acid
Hydrocortisone
Intensive care unit
Pneumonia
Thiamine

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