Vitamin C, Complex B and Hydrocortisone in Septic Patients Treated at ICU of The General Hospital 11 IMSS Piedras Negras Coahuila
Dr. Jose Ivan Rodriguez de Molina Serrano and Nurse Hugo Humberto Castro Martinez
Introduction: Sepsis is defined as severe organ disfunction as with a dysregulated response of the host with a documented or suspected infection. In Mexico sepsis represents 11,183 hospitalizations and is 27.3% of ICU admission. The Surviving Sepsis Champaign is aimed at early identification and timely treatment of these patients.
Objective: Describe the difference between ICU and hospital mortality among septic patients treated with standard treatment vs standard treatment + Vitamin C + Hydrocortisone + Thiamine + Cyanocobalamin + Pyridoxine (Complex B).
Material and Methods: A prospective, longitudinal, experimental cohort study was conducted in August 2019 to October 2020 ICU of the General Hospital of Zone 11 IMSS in Piedras Negras, Coahuila, conducted in 2 phases: Phase 1: control group: standard treatment accordingly GPC, duration of 6 months. Phase 2: experimental: standard treatment + treatment protocol that consist to Vitamin C 1.5 g IV every 6 hours, Hydrocortisone 50 mg IV every 6 hours and in case of v í enteral Complex B (Thiamine 100 mg Pyridoxine 5 mg Cyanocobalamin 50 mcg) 1 tablet every 6 hours for 4 consecutive days or until discharge of the patient; duration of 6 months.
Results: 19 patients were enrolled for this study (12 phase 1 and 7 phase 2). The general characteristics were: Age 52.4 years, Female 31.6%, BMI 33.4, main sources of infection: Pulmonary 47.4%, Abdominal 36.8%, ICU LOS 7.0 Hospital LOS 16.3; ICU and Hospital survival 73.7%, 52.6% respectively, The only statistical difference between the two groups was steroid use and CRP. The factors associated with ICU survival were: LOS, second vasopressor use, NE dose, EPI dose, CRP, and with Hospital survival were: LOS, Hydrocortisone use, SAPS3 score, SAPS3 predicted mortality, qSOFA, SOFA, Respiratory SOFA, Renal SOFA, Hematologic SOFA, second vasopressor use, EPI dose. Vitamin C, Complex B and Hydrocortisone had no statistical significance with survival. There was no difference in organic failure and vasopressor use in both groups.
Conclusion: In septic patients administration of Vitamin C, Complex B and Hydrocortisone + standard treatment vs standard treatment alone was no associated with a statistical difference in Hospital survival, organic failure or vasopresor use.