{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T15:50:03Z","timestamp":1788537003589,"version":"build-2803163510"},"reference-count":64,"publisher":"S. Karger AG","issue":"10","license":[{"start":{"date-parts":[[2024,6,13]],"date-time":"2024-06-13T00:00:00Z","timestamp":1718236800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,6,13]],"date-time":"2024-06-13T00:00:00Z","timestamp":1718236800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int Arch Allergy Immunol"],"abstract":"<jats:p>Introduction: This systematic review aimed to assess the efficacy and safety of hydrocortisone, ascorbic acid, and thiamine (HAT) combination therapy in patients with sepsis and septic shock. Methods: We conducted a database search in MEDLINE, Embase, CENTRAL, Web of Science, and CNKI for randomised controlled trials (RCTs) comparing HAT against placebo\/standard of care or against hydrocortisone in sepsis\/septic shock patients. Outcomes included mortality, ICU\/hospital length of stay (LOS), vasopressor durations, mechanical ventilation durations, change in SOFA at 72 h, and adverse events. RCT results were pooled in random-effects meta-analyses. Quality of evidence was assessed using GRADE. Results: Fifteen RCTs (N = 2,594) were included. At 72 h, HAT reduced SOFA scores from baseline (mean difference [MD] \u22121.16, 95% confidence interval [CI]: \u22121.58 to \u22120.74, I2 = 0%) compared to placebo\/SoC, based on moderate quality of evidence. HAT also reduced the duration of vasopressor use (MD \u221218.80 h, 95% CI: \u221223.67 to \u221213.93, I2 = 64%) compared to placebo\/SoC, based on moderate quality of evidence. HAT increased hospital LOS (MD 2.05 days, 95% CI: 0.15\u20133.95, I2 = 57%) compared to placebo\/SoC, based on very low quality of evidence. HAT did not increase incidence of adverse events compared to placebo\/SoC. Conclusions: HAT appears beneficial in reducing vasopressor use and improving organ function in sepsis\/septic shock patients. However, its advantages over hydrocortisone alone remain unclear. Future research should use hydrocortisone comparators and distinguish between sepsis-specific and comorbidity- or care-withdrawal-related mortality. <\/jats:p>","DOI":"10.1159\/000538959","type":"journal-article","created":{"date-parts":[[2024,7,22]],"date-time":"2024-07-22T05:46:41Z","timestamp":1721627201000},"page":"997-1018","source":"Crossref","is-referenced-by-count":5,"title":["Efficacy and Safety of Hydrocortisone, Ascorbic Acid, and Thiamine Combination Therapy for the Management of Sepsis and Septic Shock: A Systematic Review and Meta-Analysis of Randomised Controlled Trials"],"prefix":"10.1159","volume":"185","author":[{"given":"Jiawen","family":"Deng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi 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