{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T05:22:04Z","timestamp":1792819324957,"version":"4.5.0"},"reference-count":37,"publisher":"The Korean Society of Critical Care Medicine","issue":"3","license":[{"start":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T00:00:00Z","timestamp":1692576000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["2019R1G1A1099373"],"award-info":[{"award-number":["2019R1G1A1099373"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["accjournal.org"],"crossmark-restriction":true},"short-container-title":["ACC"],"published-print":{"date-parts":[[2023,8,31]]},"abstract":"<jats:p>Background: Sepsis is characterized by heterogeneous immune responses that may evolve during the course of illness. This study identified inflammatory immune responses in septic patients receiving vitamin C, hydrocortisone, and thiamine.Methods: This was a single-center, post-hoc analysis of 95 patients with septic shock who received the vitamin C protocol. Blood samples were drawn on days 1\u20132, 3\u20134, and 6\u20138 after shock onset. Group-based multi-trajectory modeling was used to identify immune trajectory groups.Results: The median age was 78 years (interquartile range, 70\u201384 years), and 56% were male. Clustering analysis identified group 1 (n=41), which was characterized by lower interleukin (IL)-6, tumor necrosis factor (TNF)-\u03b1, and IL-10 levels, and these levels remained stationary or mildly increased until day 7. Conversely, group 2 (n=54) expressed initially higher IL-6, TNF-\u03b1, and IL-10 levels that decreased rapidly by day 4. There was a nonsignificant increase in lymphocyte count and a decrease in C-reactive protein level until day 7 in group 2. The intensive care unit mortality rate was significantly lower in group 2 (39.0% vs. 18.5%, P=0.03). Group 2 also had a significantly higher decrease in the mean (standard deviation) vasopressor dose (norepinephrine equivalent, \u20130.09\u00b10.16 \u03bcg\/kg\/min vs. \u20130.23\u00b10.31 \u03bcg\/kg\/min, P&lt;0.001) and Sequential Organ Failure Assessment score (0\u00b15 vs. \u20134\u00b13, P=0.002) between days 1 and 4.Conclusions: There may be different subphenotypes in septic patients receiving the vitamin C protocol.<\/jats:p>","DOI":"10.4266\/acc.2023.00507","type":"journal-article","created":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T07:41:07Z","timestamp":1692603667000},"page":"286-297","update-policy":"https:\/\/doi.org\/10.4266\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Patterns of inflammatory immune responses in patients with septic shock receiving vitamin C, hydrocortisone, and thiamine: clustering analysis in Korea"],"prefix":"10.4266","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2430-6907","authenticated-orcid":true,"given":"Seung-Hun","family":"You","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4751-7384","authenticated-orcid":true,"given":"Oh Joo","family":"Kweon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2032-112X","authenticated-orcid":true,"given":"Sun-Young","family":"Jung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6455-0376","authenticated-orcid":true,"given":"Moon 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