{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T22:42:38Z","timestamp":1787697758527,"version":"build-2784847793"},"reference-count":69,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2021,12,6]],"date-time":"2021-12-06T00:00:00Z","timestamp":1638748800000},"content-version":"vor","delay-in-days":339,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003345","name":"Chinese Academy of Meteorological Sciences","doi-asserted-by":"publisher","award":["2019\u00a0M664003"],"award-info":[{"award-number":["2019\u00a0M664003"]}],"id":[{"id":"10.13039\/501100003345","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003345","name":"Chinese Academy of Meteorological Sciences","doi-asserted-by":"publisher","award":["2019-I2M-5-076"],"award-info":[{"award-number":["2019-I2M-5-076"]}],"id":[{"id":"10.13039\/501100003345","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2017YFC1103302"],"award-info":[{"award-number":["2017YFC1103302"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["18CXZ026"],"award-info":[{"award-number":["18CXZ026"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82002071"],"award-info":[{"award-number":["82002071"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81801935"],"award-info":[{"award-number":["81801935"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81730057"],"award-info":[{"award-number":["81730057"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The objective of this study was to evaluate the clinical efficacy of thiamine and vitamin C with or without hydrocortisone coadministration on the treatment of sepsis and septic shock.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>MEDLINE, EMBASE and CENTRAL databases were searched for randomized controlled trials (RCTs) that made a comparative study between the combination therapy of vitamin C and thiamine with or without hydrocortisone and the administration of placebo in patients with sepsis or septic shock. Two reviewers independently performed study selection, data extraction and quality assessment. Both short-term mortality and change in the sequential organ failure assessment (SOFA) score from baseline (delta SOFA) were set as the primary outcomes. Secondary endpoints included intensive care unit (ICU) mortality, new onset of acute kidney injury, total adverse events, ICU and hospital length of stay, duration of vasopressor usage and ventilator-free days. Meanwhile, trial sequential analysis was conducted for primary outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Eight RCTs with 1428 patients were included in the current study. The results showed no significant reduction of short-term mortality in sepsis and septic shock patients who received combination therapy of vitamin C and thiamine with or without hydrocortisone compared to those with placebo {risk ratio (RR), 1.02 [95% confidence interval (CI), 0.87 to 1.20], p\u2009=\u20090.81, I2\u00a0=\u20090%; risk difference (RD), 0 [95% CI, \u22120.04 to 0.05]}. Nevertheless, the combination therapy was associated with significant reduction in SOFA score [mean difference (MD), \u22120.63, (95% CI, \u22120.96 to \u22120.29, p\u2009&amp;lt;\u20090.001, I2\u00a0=\u20090%] and vasopressors duration (MD, \u221222.11 [95% CI, \u221230.46 to \u221213.77], p\u2009&amp;lt;\u20090.001, I2\u00a0=\u20096%). Additionally, there were no statistical differences in the pooled estimate for other outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In the current meta-analysis, the combination therapy of vitamin C and thiamine, with or without hydrocortisone had no impact on short-term mortality when compared with placebo, but was associated with significant reduction in SOFA score among patients with sepsis and septic shock.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/burnst\/tkab040","type":"journal-article","created":{"date-parts":[[2021,10,20]],"date-time":"2021-10-20T18:19:03Z","timestamp":1634753943000},"source":"Crossref","is-referenced-by-count":9,"title":["Combination therapy of thiamine, vitamin C and hydrocortisone in treating patients with sepsis and septic shock: a meta-analysis and trial sequential analysis"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3173-4301","authenticated-orcid":false,"given":"Renqi","family":"Yao","sequence":"first","affiliation":[{"name":"Translational Medicine Research Center, Fourth Medical Center and Medical Innovation Research Division of the Chinese PLA General Hospital, Beijing 100048, China"},{"name":"Department of Burn Surgery, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China"},{"name":"Research Unit of key techniques for treatment of burns and combined burns and trauma injury, Chinese Academy of Medical Sciences, 100730, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yibing","family":"Zhu","sequence":"additional","affiliation":[{"name":"Medical Research and Biometrics Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Changzheng Hospital, Naval Medical University, Shanghai 200003, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhixuan","family":"Li","sequence":"additional","affiliation":[{"name":"International Cooperation Laboratory on Signal Transduction, Eastern Hepatobiliary Surgery Institute, Second Military Medical University, Shanghai 200082, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lixue","family":"Wang","sequence":"additional","affiliation":[{"name":"Translational Medicine Research Center, Fourth Medical Center and Medical Innovation Research Division of the Chinese PLA General Hospital, Beijing 100048, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liyu","family":"Zheng","sequence":"additional","affiliation":[{"name":"Translational Medicine Research Center, Fourth Medical Center and Medical Innovation Research Division of the Chinese PLA General Hospital, Beijing 100048, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingyan","family":"Li","sequence":"additional","affiliation":[{"name":"Translational Medicine Research Center, Fourth Medical Center and Medical Innovation Research Division of the Chinese PLA General Hospital, Beijing 100048, China"},{"name":"Department of Emergency, The Second Hospital of Hebei Medical University, Hebei 050000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huibin","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Beijing Tsinghua Chang Gung Hospital, Beijing 102218, China"},{"name":"Medical ICU, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2212-8489","authenticated-orcid":false,"given":"Guosheng","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Burn Surgery, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China"},{"name":"Research Unit of key techniques for treatment of burns and combined burns and trauma injury, Chinese Academy of Medical Sciences, 100730, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200120, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6512-7171","authenticated-orcid":false,"given":"Zhaofan","family":"Xia","sequence":"additional","affiliation":[{"name":"Department of Burn Surgery, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China"},{"name":"Research Unit of key techniques for treatment of burns and combined burns and trauma injury, Chinese Academy of Medical Sciences, 100730, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Ren","sequence":"additional","affiliation":[{"name":"Translational Medicine Research Center, Fourth Medical Center and Medical Innovation Research Division of the Chinese PLA General Hospital, Beijing 100048, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongming","family":"Yao","sequence":"additional","affiliation":[{"name":"Translational Medicine Research Center, Fourth Medical Center and Medical Innovation Research Division of the Chinese PLA General Hospital, Beijing 100048, 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