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Tag: Vitamin C

The ORANGES Trial: Why You Can’t Just Read the Abstract

Background: The cornerstones of sepsis management continues to include early identification, early appropriate empiric antibiotics, definitive source control, and vasopressors to support end organ perfusion. There have been multiple studies looking at the co-administration of hydrocortisone, ascorbic acid, and thiamine …

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Infectious Disease

The HYVCTTSSS Trial: The “Metabolic Cocktail” in Another RCT

Background: Getting the basics right in all illness is vital. In sepsis, this means appropriate use of antibiotics, judicious fluid resuscitation, and early identification.  Vasopressor support is also essential in the sickest sepsis patients (i.e. septic shock). Should the metabolic …

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Infectious Disease

REBEL Cast Ep74 – Is it all About the VITAMINS in Sepsis?

Background: The combination of vitamin C, hydrocortisone and thiamine in sepsis has been a topic of hot debate in the past couple years.  There is a hypothetical pathophysiological basis to make an argument for the use of this combination of …

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Infectious DiseaseResuscitation

CITRIS-ALI: Vitamin C in Patients with Sepsis and Severe Acute Respiratory Failure

Background: In 2016, Paul Marik published a study in Chest [2] demonstrating a decrease in hospital mortality of 32% for sepsis patients treated with vitamin C, thiamine and hydrocortisone.  The Marik protocol(as it has come to be known), entails IV …

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Infectious Disease

The Marik Protocol: Have We Found a “Cure” for Severe Sepsis and Septic Shock?

Background: The overall mortality in sepsis has decreased quite a bit in the last decade or so, however for a subset of patients, like those with Septic Shock, the mortality still remains high (as high as 50%).  There have been …

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Infectious Disease

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