Comments on: A new and more effective sepsis treatment?

By: Art Deco

Art Deco — Fri, 01 Jun 2018 13:09:07 +0000

Art Deco: Linus Pauling had a phenomenal scientific career. He won a Nobel Prize in Chemistry and he makes lists of the twenty most important scientists of all time. It wasn’t unreasonable to trust his judgment.

Physiology wasn’t really his field. One of his avocations was non-electoral politics of a quasi-pacifist red haze variety, not something about which we should be inclined to trust his judgment.

By: JTW

JTW — Thu, 31 May 2018 16:27:03 +0000

Sepsis comes in many forms and can have many causes. This specific cocktail may well work for some of them and the “researchers” got lucky (or stacked the deck) to get the results they were looking for.

My mother died from sepsis caused by a combination of cancer, kidney failure, and hypercalcemia.
In the end the cancer caused the hypercalcemia which couldn’t be relieved because her kidneys were incapable of handling the amount of liquids it would take to flush the toxins out of her system.

I seriously doubt giving her some vitamins and anti-inflamatories would have done her any good.

By: huxley

huxley — Thu, 31 May 2018 15:44:50 +0000

My mother and father were very susceptible to claims about Vitamin C (Linus Pauling, Norman Cousins).

Unfortunately he was persuaded by his own recovery from Bright’s disease using an unorthodox approach which included vitamin supplements.

Such confirmation bias was behind much of the megavitamin bandwagon which got rolling in the sixties and seventies but faded for lack of results.

For a long time I took large doses of C when I had a cold but found it didn’t help.

By: om

om — Thu, 31 May 2018 14:22:09 +0000

The human body repairs itself until it can’t. The process is aging and it’s called death, by cancer or disease, or just plain old wearing out.

By: Art Deco

Art Deco — Thu, 31 May 2018 11:21:05 +0000

Color me skeptical.

My mother and father were very susceptible to claims about Vitamin C (Linus Pauling, Norman Cousins). Never knew why.

By: Tom Murin

Tom Murin — Thu, 31 May 2018 05:54:41 +0000

We will see. Something can work without knowing why exactly – they can figure the science out later.

By: ymarsakar

ymarsakar — Thu, 31 May 2018 05:42:52 +0000

In other words, the human body will repair itself if it has the requisite materials on hand. This would explain the prevalence of diseases as a result of mineral and nutrition depletion from modern agriculture practices.

By: Frog

Frog — Thu, 31 May 2018 03:23:03 +0000

I have read the full paper. I am not and never have been an ICU doc.
The rationale for the use of the three drug combo in sepsis is well-presented in the Discussion part of the paper, including that Vit C and hydrocortisone “are
required for the synthesis of catecholamines; and
increase vasopressor sensitivity.” And so boost blood pressure, which is beneficial for sure in septic shock.

I now view the prospect of a larger clinical trial with some optimism. A historical trial, as this paper reports, does in fact have some validity. The gold standard, a prospective randomized double-blinded clinical trial, takes time and may in fact show no difference between the two groups. But in the meantime, if I go into septic shock, I will want the B-1, C, plus HC combo.

By: groundhog

groundhog — Thu, 31 May 2018 02:07:48 +0000

Can’t argue with doing more trials. Some people just set up shop and start selling miracle cures.

By: Cornflour

Cornflour — Thu, 31 May 2018 01:09:39 +0000

For those curious about this line of research, I’ve copied a paragraph, from Marik’s most recent paper, describing the status of a number of clinical trials. Most are in the early stages, but their progress and results can be followed at https://clinicaltrials.gov/ and http://www.anzctr.org.au/BasicSearch.aspx.

Vitamin C for the treatment of sepsis: The scientific rationale. Marik PE. Pharmacol Ther. 2018 Apr 21. pii: S0163-7258(18)30070-6

In a retrospective, propensity adjusted, before-after study, we have demonstrated that the combination of intravenous vitamin C, hydrocortisone and thiamine limited the development of organ failure and improved the outcome of patients with severe sepsis and septic shock (Marik et al., 2017). We believe that this inexpensive, readily available and extremely safe intervention has the potential to reduce the global mortality from sepsis.

However, due to the limitations of our study, additional studies are required to confirm our preliminary findings. Several randomized controlled trials are currently underway across the globe to determine the clinical benefit of vitamin C alone (clintrials.gov NCT03338569,NCT02106975, NCT02734147, ACTRN12617000793314,ACTRN12617001184369,ACTRN12617001392358p) and in combination with hydrocortisone and thiamine (clinicaltrials.gov NCT03333278, NCT03335124, NCT03258684, NCT 03380507,NCT03422159, NCT03389555).

In addition, the VICTAS study (Vitamin C, Thiamine and Steroids in Sepsis: A Randomized, Double-Blind, Parallel Group Study in Critically Ill Patients with Sepsis) is a large, multi-center study which will be performed in the USA.