Objective: To investigate the effects of hydrocortisone combined with vitamin C and vitamin B1 versus hydrocortisone on sublingual microcirculation in septic shock patients.
Methods: This pilot study enrolled septic shock patients admitted to the ICU of a tertiary teaching hospital from February 2019 to January 2020. We randomly assigned the enrolled patients to the treatment group (hydrocortisone combined with vitamin C and vitamin B1 added to standard care) and the control group (hydrocortisone alone added to standard care) in a 1 : 1 ratio. The primary outcome was perfused small vascular density (sPVD) monitored by a sublingual microcirculation imaging system at 24 hours after treatment.
Results: Twelve patients in the treatment group and ten in the control group completed the study. The baseline characteristics were comparable between the groups. No statistically significant difference was found in the sPVD between the groups at baseline. The sPVD in the treatment group was significantly higher than that in the control group at 4 hours after treatment (mean difference, 7.042; 95% CI, 2.227-11.857; P = 0.009) and 24 hours after treatment (mean difference, 7.075; 95% CI, 2.390-11.759; P = 0.008).
Conclusions: Compared with hydrocortisone, hydrocortisone combined with vitamin C and vitamin B1 significantly improves microcirculation in septic shock patients.
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http://dx.doi.org/10.3233/CH-221444 | DOI Listing |
Indian J Crit Care Med
December 2024
Department of Critical Care Medicine, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Bagmati, Nepal.
Aims And Background: Glucocorticoids, vitamin C and thiamine have important biological effects in patients with sepsis and septic shock. Multiple studies have demonstrated the beneficial role of a combination therapy of vitamin C, hydrocortisone and thiamine in patients with sepsis and septic shock in terms of mortality reduction, and increase in the number of days free of ventilators and vasopressors.
Materials And Methods: Patients who had septic shock were assessed for eligibility after intensive care unit (ICU) admission.
Pharmacoecon Open
December 2024
Erasmus School of Health Policy & Management (ESHPM) & Erasmus Centre for Health Economics Rotterdam (EsCHER), Erasmus University Rotterdam, Burgemeester Oudlaan 50, 3062 PA, Rotterdam, The Netherlands.
Background: Pharmaceutical three-dimensional printing (3DP) technology offers an automated platform that can be utilized to manufacture personalized medicine, improving pharmacotherapy. Although 3D-printed products have entered clinical trials, no costing studies have been performed yet. Cost insights can aid researchers and industry in making informed decisions about the feasibility and scalability of 3DP.
View Article and Find Full Text PDFPediatr Crit Care Med
December 2024
Children's Intensive Care Research Program, Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.
Transl Psychiatry
December 2024
College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China.
Accumulating studies have highlighted the links between stress-related networks and the HPA axis for emotion regulation and proved the mapping associations between altered structural and functional networks (called SC-FC coupling) in depression. However, the signatures of SC-FC coupling in subthreshold depression (StD) individuals and their relationships with HPA axis reactivity, as well as the predictive power of these combinations for discriminating StD, remain unclear. This cross-sectional study enrolled 160 adults, including 117 StD and 43 healthy controls (HC).
View Article and Find Full Text PDFNutrients
December 2024
Scientific Direction, National Institute of Gastroenterology IRCCS "Saverio de Bellis", 70013 Castellana Grotte, BA, Italy.
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