Introduction:
Sepsis is a medical emergency especially in patients with renal failure, resulting in a significant increase in morbidity and mortality. Intravenous Vitamin C and Intravenous Thiamine (Marvik Protocol) are useful in sepsis patients. This study aims to determine the effectiveness of Inj. Vitamin C and Inj.Thiamine in patients with renal failure and sepsis.
Methods:
The present study was a randomized, placebo-controlled trial. There were 198 patients enrolled in the study. Of 198, 96 patients were in the treatment arm and 102 patients in the control arm. All patients were adults, e GFR < 25 ml/minute, serum procalcitonin >25 ng/ml at admission, and survived more than 24 hours were included in the study. Inj.Vitamin C at 1.5 gm IV every 6 hours, and Inj.Thiamine 200mg IV every 12 hours was given in the treatment arm. Both groups received hydrocortisone. Patients’ demographics, and biochemical tests, such as renal profile, CBC, Blood Sugar, and serum procalcitonin on Day 1 and 4 were measured as per the standard protocol. The primary outcome was hospital mortality, recovery, and percentage reduction of procalcitonin. Institutional Ethical Committee approval was obtained. All patients were informed and written consent was obtained before the study.
Results:
A total of 198 patients underwent randomization. The primary outcome was a higher recovery rate of 88% in the control group vs 78% in the treatment group which was not statistically significant (P=0.6337). Death occurred in 22 patients (22.9%) in the treatment group Vs Nil in the control group which was statistically significant (P<0.0001). The statically significant reduction of Procalcitonin on Day 4 vs 1, 55% in the control group vs 30.13% in the treatment arm (P=0.0003).
Conclusions:
In adults with sepsis and e GFR <25 ml/minute, those who received Vitamin C and Thiamine had a higher risk of death, with a lesser reduction of Procalcitonin on Day 4 when compared to placebo. Additional research with the larger population, early administration, and long-term follow-up is necessary to confirm these findings.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.