Vitamin C, Complex B and Hydrocortisone in Septic Patients Treated at ICU of The General Hospital 11 IMSS Piedras Negras Coahuila

Abstract

Introduction: Sepsis is defined as severe organ disfunction as with a dysregulated response of the host with a documented or suspected infection. In Mexico sepsis represents 11,183 hospitalizations and is 27.3% of ICU admission. The Surviving Sepsis Champaign is aimed at early identification and timely treatment of these patients. Objective: Describe the difference between ICU and hospital mortality among septic patients treated with standard treatment vs standard treatment + Vitamin C + Hydrocortisone + Thiamine + Cyanocobalamin + Pyridoxine (Complex B). Material and Methods: A prospective, longitudinal, experimental cohort study was conducted in August 2019 to October 2020 ICU of the General Hospital of Zone 11 IMSS in Piedras Negras, Coahuila, conducted in 2 phases: Phase 1: control group: standard treatment accordingly GPC, duration of 6 months. Phase 2: experimental: standard treatment + treatment protocol that consist to Vitamin C 1.5 g IV every 6 hours, Hydrocortisone 50 mg IV every 6 hours and in case of v í enteral Complex B (Thiamine 100 mg Pyridoxine 5 mg Cyanocobalamin 50 mcg) 1 tablet every 6 hours for 4 consecutive days or until discharge of the patient; duration of 6 months. Results: 19 patients were enrolled for this study (12 phase 1 and 7 phase 2). The general characteristics were: Age 52.4 years, Female 31.6%, BMI 33.4, main sources of infection: Pulmonary 47.4%, Abdominal 36.8%, ICU LOS 7.0 Hospital LOS 16.3; ICU and Hospital survival 73.7%, 52.6% respectively, The only statistical difference between the two groups was steroid use and CRP. The factors associated with ICU survival were: LOS, second vasopressor use, NE dose, EPI dose, CRP, and with Hospital survival were: LOS, Hydrocortisone use, SAPS3 score, SAPS3 predicted mortality, qSOFA, SOFA, Respiratory SOFA, Renal SOFA, Hematologic SOFA, second vasopressor use, EPI dose. Vitamin C, Complex B and Hydrocortisone had no statistical significance with survival. There was no difference in organic failure and vasopressor use in both groups. Conclusion: In septic patients administration of Vitamin C, Complex B and Hydrocortisone + standard treatment vs standard treatment alone was no associated with a statistical difference in Hospital survival, organic failure or vasopresor use.