In this episode, I’ll discuss the state of research for hydrocortisone, ascorbic acid, and thiamine (HAT Rx) for sepsis.
It has been nearly 2 and a half years since the publication of Paul Marik’s retrospective before-after study of hydrocortisone, ascorbic acid, and thiamine to treat septic shock.
According to clinicaltrials.gov, 16 studies testing this therapy have been declared. Of these, 1 was terminated for low enrollment, 14 have not progressed passed the recruiting stage, and 1 study has been completed but no results have been posted yet.
The completed study was done by the Department of Critical Care Medicine of Zhujiang Hospital.
The completed study is a randomized, placebo-controlled trial that appears to have enrolled 80 patients out of an initially planned 140.
The active comparator group used the following protocol:
Intravenous vitamin C (1.5 g every 6 h for 4 days or until ICU discharge), hydrocortisone (50 mg every 6 h for 7 days or until ICU discharge followed by a taper over 3 days), as well as intravenous thiamine (200 mg every 12 h for 4 days or until ICU discharge).
The placebo group received only saline.
The status of the study was changed to completed in March of 2019.
Unfortunately, I am not able to find any contact information for the investigators to inquire about a preliminary description of the results.
It is exciting to know we are one step closer to having some more data on the efficacy of hydrocortisone, ascorbic acid, and thiamine to treat septic shock, and I will share more about the results on this podcast when I learn about them.
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