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Early Vitamin C, Hydrocortisone, and Thiamine Treatment for Septic Cardiomyopathy: A Propensity Score Analysis

Min-Taek Lee1, Sun-Young Jung1,2, Moon Seong Baek3

  • 1Department of Global Innovative Drugs, The Graduate School of Chung-Ang University, Chung-Ang University, Seoul 06974, Korea.

Journal of Personalized Medicine
|July 2, 2021
PubMed

Insights

Early vitamin C, hydrocortisone, and thiamine (the vitamin C protocol) may reduce intensive care unit mortality in septic cardiomyopathy patients. Prompt administration within 2 hours of diagnosis showed the best outcomes, improving organ function and lowering death risk.

Area of Science:

  • Critical Care Medicine
  • Clinical Nutrition
  • Sepsis Research

Background:

  • Septic cardiomyopathy is a severe complication of sepsis, characterized by cardiac dysfunction.
  • Current treatments for septic cardiomyopathy have limited efficacy, necessitating novel therapeutic approaches.
  • Early administration of vitamin C, hydrocortisone, and thiamine has been proposed as a potential intervention.

Purpose of the Study:

  • To evaluate the effectiveness of an early vitamin C protocol in patients with septic cardiomyopathy.
  • To compare outcomes between patients receiving the vitamin C protocol and a control group.
  • To determine the impact of treatment timing on patient mortality and organ dysfunction.

Main Methods:

  • A retrospective study comparing 91 patients who received the vitamin C protocol with 75 control patients.
  • Propensity score (PS)-matching and inverse probability of treatment weighting (IPTW) were used for cohort matching.
  • Key outcome measures included intensive care unit (ICU) mortality, vasopressor dosage, C-reactive protein (CRP) levels, and Sequential Organ Failure Assessment (SOFA) scores.

Main Results:

  • The vitamin C protocol was associated with a significantly lower risk of ICU mortality in both PS-matched (aHR: 0.55) and IPTW-matched (aHR: 0.67) cohorts.
  • In the PS-matched cohort, the protocol led to decreased vasopressor dosage, CRP concentration, and SOFA scores.
  • Patients receiving the vitamin C protocol within 2 hours of diagnosis exhibited the highest vasopressor weaning rate and lowest mortality.

Conclusions:

  • Early administration of the vitamin C protocol may improve organ dysfunction in septic cardiomyopathy.
  • The findings suggest that the vitamin C protocol could be a beneficial adjunctive therapy for septic cardiomyopathy, particularly when initiated early.
  • Further prospective studies are warranted to confirm these results and optimize treatment protocols.

Keywords:
ascorbic acidcardiomyopathieshydrocortisonesepsisseptic shockthiamine

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