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In 2017, treating patients who had sepsis and septic shock with vitamin C, thiamine, and glucocorticoids became the hottest topic of discussion in critical care. A single center reported remarkably lower mortality in patients treated with these medications (NEJM JW Gen Med Aug 15 2017 and Chest 2017; 151:1229). Since that time, multiple randomized controlled trials have failed to demonstrate the same effect (NEJM JW Gen Med Dec 15 2019 and JAMA 2019; 322:1261; NEJM JW Gen Med Feb 15 2020 and JAMA 2020; 323:423).
In this multisite U.S. trial, investigators randomized patients with sepsis-induced respiratory or cardiovascular dysfunction to intravenous vitamin C, thiamine, and hydrocortisone (1.5 g, 100 mg, and 50 mg, respectively, given every…