Ragoonanan David, Tran Nicolas, Modi Veeshal, Morgan Nickelsen Paige
Department of Pharmacy Services, Sarasota Memorial Hospital, Sarasota, FL, USA.
Department of Pharmacy Services, Tampa General Hospital, Tampa, FL, USA.
Am J Health Syst Pharm. 2022 Sep 22;79(19):1626-1633. doi: 10.1093/ajhp/zxac169.
To evaluate current evidence on the utility of hydrocortisone, ascorbic acid, and thiamine (HAT) therapy for the management of septic shock.
The following keyword search terms were utilized in PubMed to identify relevant articles: ascorbic acid, thiamine, hydrocortisone, shock, and critical care. Articles relevant to HAT therapy in patients with septic shock were selected. Retrospective cohorts and randomized controlled trials were included in this review; case reports/series were excluded. Data from included studies illustrating the use of HAT therapy for the management of sepsis and septic shock, including data on time to HAT therapy initiation, severity of illness at baseline, duration of vasopressor therapy, progression of organ failure, and mortality, were evaluated.
The utilization of HAT therapy for the management of sepsis and septic shock remains controversial. Hemodynamic benefits have been shown to be most pronounced when HAT therapy is initiated earlier. Future studies directed at earlier initiation may be necessary to confirm this theory.
评估目前关于氢化可的松、维生素C和硫胺素（HAT）疗法用于治疗感染性休克的证据。
在PubMed中使用了以下关键词搜索词来识别相关文章：维生素C、硫胺素、氢化可的松、休克和重症监护。选择了与感染性休克患者的HAT疗法相关的文章。本综述纳入了回顾性队列研究和随机对照试验；排除了病例报告/系列研究。评估了纳入研究中说明HAT疗法用于治疗脓毒症和感染性休克的数据，包括开始HAT治疗的时间、基线时的疾病严重程度、血管升压药治疗的持续时间、器官衰竭的进展情况和死亡率。
HAT疗法用于治疗脓毒症和感染性休克仍存在争议。当更早开始HAT治疗时，血流动力学益处最为明显。可能需要针对更早开始治疗的未来研究来证实这一理论。
