Hydrocortisone, vitamin C, thiamine and fludrocortisone (sepsis cocktail) for adults with severe sepsis and septic shock: Open-label randomized controlled trial


  • Parinya Ruenwilai Department of Internal Medicine, Lamphun Hospital


sepsis cocktail, severe sepsis, septic shock


Sepsis is a global burden and has a high morbidity and mortality rate. Despite advances in critical care practices, sepsis remains the most common cause of death in intensive care units (ICUs). The objective of this study is to compare the mortality rate between severely septic and septic patients who used the ‘sepsis cocktail’, which contains hydrocortisone, vitamin C, thiamine, and fludrocortisone in both the ICU and the standard care group. The design of this study used an open-label randomized controlled trial. The data was collected in Law Phun hospital from May to June 2018 in relation to in-hospital mortality. There were 35 patients in both groups, with an average age of 63.0 ± 16.1 year and 60% were male. There were 17 subjects in the treatment group and 18 subjects in the control group, respectively. There were no significant differences in terms of baseline characteristics between the two groups except for lactate. The in-hospital mortality rate was significantly lower in the treatment group compared to the control group (11.8% vs. 44.4%, p=0.032). The median duration of length of stay was also a significant decrease in the intervention group compared to the control groups ([41.0 hours (26.1-76.7) vs. 96.0 (86.3-120.0), p=0.001)]. In conclusion, these results suggest that the adjunctive use of the sepsis cocktail and corticosteroid were effective in reducing the mortality and the length of stay of patients with severe sepsis and septic shock.


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Original Article (บทความวิจัย)