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논문 기본 정보

자료유형
학술저널
저자정보
Manoj Kumar Reddy Somagutta (Department of Clinical and Translational Research Larkin Community Hospital South Miami FL USA) Maria Kezia Lourdes Pormento (Department of Clinical and Translational Research Larkin Community Hospital South Miami FL USA) Muhammad Adnan Khan (Larkin Community Hospital Miami FL USA.) Alaa Hamdan (Department of Clinical and Translational Research Larkin Community Hospital South Miami FL USA) Namrata Hange (Department of Clinical and Translational Research Larkin Community Hospital South Miami FL USA) Manish KC (Department of Clinical and Translational Research Larkin Community Hospital South Miami FL USA) Sukrut Pagad (Department of Clinical and Translational Research Larkin Community Hospital South Miami FL USA) Molly Sanjay Jain (Department of Medicine Saint James School of Medicine Park Ridge IL USA) Sivasthikka Lingarajah (Department of Medicine Windsor University School of Medicine Cayon (St. Kitts and Nevis) USA) Vishal Sharma (Department of Medicine Windsor University School of Medicine Cayon (St. Kitts and Nevis) USA) Jaspreet Kaur (Department of Medicine Medical University of Silesia Katowice Poland) Bernard Emuze (Department of Medicine Saint James School of Medicine Park Ridge IL USA) Erkan Batti (Department of Medicine Washington University of Health and Science San Pedro Belize) Obumneme Jude Iloeje (Department of Medicine University of Health Sciences Antigua Antigua and Barbuda)
저널정보
대한중환자의학회 Acute and Critical Care Acute and Critical Care 제36권 제3호
발행연도
2021.8
수록면
185 - 200 (16page)
DOI
10.4266/acc.2021.00108

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Background: Previous studies have suggested favorable outcomes of hydrocortisone, ascorbic acid (vitamin C), and thiamine (HAT) therapy in patients with sepsis. However, similar results have not been duplicated in sequential studies. This meta-analysis aimed to reevaluate the value of HAT treatment in patients with sepsis. Methods: Electronic databases were searched up until October 2020 for any studies that compared the effect of HAT versus non-HAT use in patients with sepsis. Results: Data from 15 studies (eight randomized controlled trials [RCTs] and seven cohort studies) involving 67,349 patients were included. The results from the RCTs show no significant benefit of triple therapy on hospital mortality (risk ratio [RR], 0.99; P=0.92; I2=0%); intensive care unit (ICU) mortality (RR, 0.77; P=0.20; I2=58%); ICU length of stay (weighted mean difference [WMD], 0.11; P=0.86; I2=37%) or hospital length of stay (WMD: 0.57; P=0.49; I2=17%), and renal replacement therapy (RR, 0.64; P=0.44; I2=39%). The delta Sequential Organ Failure Assessment (SOFA) score favored treatment after a sensitivity analysis (WMD, ?0.72; P=0.01; I2=32%). However, a significant effect was noted for the duration of vasopressor use (WMD, ?25.49; P<0.001; I2=46%). The results from cohort studies have also shown no significant benefit of HAT therapy on hospital mortality, ICU mortality, ICU length of stay, length of hospital stay, the delta SOFA score, the use of renal replacement therapy, or vasopressor duration. Conclusions: HAT therapy significantly reduced the duration of vasopressor use and improved the SOFA score but appeared not to have significant benefits in other outcomes for patients with sepsis. Further RCTs can help understand its benefit exclusively.

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