• Tae Gun Shin, Youn-Jung Kim, Seung Mok Ryoo, Sung Yeon Hwang, Ik Joon Jo, Sung Phil Chung, Sung-Hyuk Choi, Gil Joon Suh, and Won Young Kim.
• Departm and nd t of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea. taegunshin@skku.edu.
• J Clin Med. 2019 Jan 16; 8 (1).

BackgroundIntravenous vitamin C and thiamine administration may be a potential adjuvant therapy for septic shock. We aimed to investigate the impact of early vitamin C and thiamine administration in septic shock patients.MethodsThis retrospective before-and-after cohort study used data extracted from the Korean Shock Society's prospective septic shock registry. We compared 28-day and in-hospital mortality rates between patients treated with intravenous vitamin C (3 g/12 h or 1.5 g/6 h) and thiamine (200 mg/12 h) <6 hours after shock recognition from July through December 2017 (n = 229) and control patients from October 2015 through June 2017 (n = 915) using propensity score matching.ResultsThe 28-day (18.3% vs. 17.5%; P = 0.76) and in-hospital (16.6% vs. 18.3%; P = 0.55) mortality rates did not differ between treatment and control groups, nor did 28-day (18.5% vs. 17.5%; P = 0.84) and in-hospital (16.7% vs. 18.4%; P = 0.54) mortality rates after matching. In the subgroup analysis, treatment was associated with lower in-hospital mortality rates in patients with albumin <3.0 mg/dL or a Sequential Organ Failure Assessment (SOFA) score >10.ConclusionEarly vitamin C and thiamine administration in patients with septic shock did not improve survival; however, administration could benefit conditions that are more severe, such as hypoalbuminemia or severe organ failure.

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