Combined treatment with vitamin C, hydrocortisone and thiamine does not attenuate morbidity and mortality of septic sheep

TL;DR

A combination of vitamin C, hydrocortisone, and thiamine did not reduce illness or death in sheep with sepsis.

Contribution

The study shows that combined vitamin C, hydrocortisone, and thiamine therapy is ineffective in treating sepsis in sheep.

Findings

The treatment group had a higher survival rate (33.3%) than the control group (16.7%), but the difference was not significant.

The combined therapy did not improve blood pressure, lung function, or fluid accumulation in the chest cavity.

The treatment group had more bacteria in the lungs compared to the control group.

Abstract

Sepsis is associated with a highest mortality rate in the ICU. Present study tests the efficacy of combined therapy with vitamin C, hydrocortisone and thiamine (combined therapy) in the ovine model of sepsis induced by Pseudomonas aeruginosa. In this study, sepsis was induced in sheep by instillation of Pseudomonas aeruginosa (1 × 1011 CFU) into the lungs via bronchoscope, under anesthesia. Nine hours after injury, intravenous infusion of vitamin C (0.75 g every 6 h), hydrocortisone (25 mg every 6 h), and thiamine (100 mg every 12 h) or saline was given to the treatment and control groups. Cardiopulmonary variables were recorded.

The survival rate was 16.7% in control and 33.3% in treatment groups. In the control group, mean arterial pressure dropped from 93.6 ± 8.6 to 75.5 ± 9.7 mmHg by 9 h, which was not affected by the combined therapy. Pulmonary dysfunction was not attenuated by the combined therapy either. The combined therapy had no effect on increased extravascular lung water content and fluid effusion into thoracic cavity. The bacterial number in the bronchoalveolar lavage fluid was significantly increased in the treatment group than the control group. The blood bacterial number remained comparable between groups.

Combined vitamin C, hydrocortisone, and thiamine did not attenuate severity of ovine sepsis.

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