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Effects of hydrocortisone combined with vitamin C and vitamin B1 versus hydrocortisone alone on microcirculation in septic shock patients: A pilot study.

  • 2023-07-18
  • Clinical hemorheology and microcirculation 84(2)
    • Jinlong Wang
    • Qianwen Song
    • Shuhe Yang
    • Haofei Wang
    • Shanshan Meng
    • Lili Huang
    • Qing Li
    • Jingyuan Xu
    • Jianfeng Xie
    • Yingzi Huang

Study Design

Type
Randomized Controlled Trial (RCT)
Population
septic shock patients
Methods
Randomized pilot study, 1:1 ratio, hydrocortisone combined with vitamin C and vitamin B1 vs hydrocortisone alone, added to standard care
Duration
24 hours after treatment
Funding
Unclear

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.

Research Insights

  • Vitamin B1→Improved Small Vessel Density

    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).

    Effect
    Beneficial
    Effect size
    Large
  • Vitamin C→Improved Small Vessel Density

    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).

    Effect
    Beneficial
    Effect size
    Large
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