Key knowledge here:
Vitamin C and Thiamine Vit B1 is not producable by human body but consumable.
Storage is limited and can be depleted in stress condition
In sepsis, vitamin C can be as low as undetectable in most of patient. A third of sepsis patient have low thiamine.
Vitamin C – required to produce cathecholamine
Thiamine – lack of thiamine can lead to wet beriberi. Mimic distrubutive shock
If we combine the lack of these two vitamins. Lead to profound shock
But we know, nobody measure it and it pass unnoticed.
Vitamin C and thiamine is quite safe. A lot of study and proved.
For time being no large and multicenter RCT (level I evident)
But nearly all of our current therapies for sepsis lack level-I evidence.
Multiple research have shown, reduce in vasopressor use, ventilatory support and mortality.
So far, we have HYPRESS, talk about role of hydrocortisone.
So Dr Marik combine these 3 things up = Dr Marik’s cocktail.
So far have a good outcome.
In conclusion : it’s safe, no harm to give. But not in guideline yet. Up to HOD.
Here the cocktails guys. IV not stir up. Hahaha.