Effect of Vitamin C, Thiamine, and Hydrocortisone on Ventilator- and Vasopressor-Free Days in Patients With Sepsis
Sevransky J, Rothman R, Hager D, Bernard G, Brown S, Buchman T, Busse L, Coopersmith C, DeWilde C, Ely E, Eyzaguirre L, Fowler A, Gaieski D, Gong M, Hall A, Hinson J, Hooper M, Kelen G, Khan A, Levine M, Lewis R, Lindsell C, Marlin J, McGlothlin A, Moore B, Nugent K, Nwosu S, Polito C, Rice T, Ricketts E, Rudolph C, Sanfilippo F, Viele K, Martin G, Wright D, Nugent K, Spainhour C, Polito C, Moore B, Negrin L, Khan A, Kea B, Krol O, Haq E, Pinkert V, Nguyen K, Brown S, Bledsoe J, Peltan I, Applegate D, Armbruster B, Montgomery Q, Brown K, Daw A, Gong M, Aboodi M, Chen J, Hope A, Gummadi S, Lopez B, Hinson J, Hager D, Ricketts E, Clements C, Gajic O, Kashyap R, Vanmeter D, Busse L, McBride M, Ginde A, Moss M, Finck L, Howell M, McKeehan J, Higgins C, Clare J, McBryde B, Barksdale A, Kalin D, Kruse D, Hilz K, Qadir N, Chang S, Beutler R, Tam A, Harris E, Youngquist S, Middleton E, Davidov E, Plante A, Belsky J, Siner J, Wira C, Brokowski C, Steingrub J, Smithline H, Thornton-Thompson S, Fowler A, Miller S, Narron K, Puskarich M, Prekker M, Hendrickson A, Quinn J, Wilson J, Levitt J, Mann R, Visweswaran A, Gentile N, Marchetti N, Reimer H, Guirgis F, Jones L, Black L, Henson M, Meyer N, Greenwood J, Ittner C, Rivers E, Jayaprakash N, Gardner-Gray J, Hurst G, Pflaum J, Jaehne A, Gill J, Cook A, Janz D, Vonderhaar D, Romaine C, Wilkerson R, McCurdy M, Beach D, Lasko K, Gill R, Price K, Dickson L, Duggal A, Mace S, Hite R, Hastings A, Haukoos J, Douglas I, Trent S, Lyle C, Cupelo A, Gravitz S, Hiller T, Oakes J, LoVecchio F, Quiroga P, Danley S, Mulrow M, Encinas A, Goodwin A, Hall G, Grady A, Exline M, Terndrup T, Pannu S, Robart E, Karow S, Files D, Smith L, Gibbs K, Flores L, Pastores S, Shaz D, Kostelecky N, Case C, Wilkins E, Gaieski D, Baram M, Schwegler D, Renzi N, Mosier J, Hypes C, Campbell E, Hooper M, Sill J, Mitchell K, Hudock K, Lyons M, Gorder K, Ahmad Y, Studer A, Davis J, Barrett M, Nomura J, Knox J, Park P, Co I, McSparron J, Hyzy R, McDonough K, Hanna S, Self W, Semler M, Hays M, Bartz R, Limkakeng A, Sweeney K, Woodburn R, Goyal M, Zaaqoq A, Moriarty T, Oropello J, Zhang Z. Effect of Vitamin C, Thiamine, and Hydrocortisone on Ventilator- and Vasopressor-Free Days in Patients With Sepsis. JAMA 2021, 325: 742-750. PMID: 33620405, PMCID: PMC7903252, DOI: 10.1001/jama.2020.24505.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAnti-Inflammatory AgentsAscorbic AcidCritical IllnessDouble-Blind MethodDrug Therapy, CombinationEarly Termination of Clinical TrialsFemaleHumansHydrocortisoneLength of StayMaleMiddle AgedOrgan Dysfunction ScoresRespiration, ArtificialRespiratory InsufficiencySepsisThiamineTreatment OutcomeVasoconstrictor AgentsVitaminsConceptsVasopressor-free daysIntensive care unitVitamin CPlacebo groupCare unitIntervention groupDays of randomizationIntravenous vitamin CPlacebo-controlled trialThirty-day mortalityTotal daily doseKey secondary outcomesAdult patientsSecondary outcomesDaily doseIll patientsPrimary outcomeSubstantial morbidityCardiovascular dysfunctionEmergency departmentCommon syndromeMAIN OUTCOMESepsisPlaceboPatientsF-Actin is associated with a worsening qSOFA score and intensive care unit admission in emergency department patients at risk for sepsis
Belsky JB, Filbin MR, Rivers EP, Bobbitt KR, Jaehne AK, Wisnik CA, Maciejewski KR, Li F, Morris DC. F-Actin is associated with a worsening qSOFA score and intensive care unit admission in emergency department patients at risk for sepsis. Biomarkers 2020, 25: 391-396. PMID: 32421363, DOI: 10.1080/1354750x.2020.1771419.Peer-Reviewed Original ResearchConceptsIntensive care unitEmergency departmentQSOFA scoreIllness severityPlasma levelsThymosin beta 4Quick Sequential Organ Failure Assessment (qSOFA) scoreSequential Organ Failure Assessment scoreIntensive care unit admissionOrgan Failure Assessment scoreCare unit admissionPositive urine cultureSymptoms of sepsisSystemic inflammatory syndromeDiagnosis of sepsisEmergency department patientsSignificant outcome measureBeta 4Unit admissionICU admissionInflammatory syndromeDepartment patientsSeptic shockCare unitED patientsAntibiotic Delays and Feasibility of a 1-Hour-From-Triage Antibiotic Requirement: Analysis of an Emergency Department Sepsis Quality Improvement Database
Filbin MR, Thorsen JE, Zachary TM, Lynch JC, Matsushima M, Belsky JB, Heldt T, Reisner AT. Antibiotic Delays and Feasibility of a 1-Hour-From-Triage Antibiotic Requirement: Analysis of an Emergency Department Sepsis Quality Improvement Database. Annals Of Emergency Medicine 2019, 75: 93-99. PMID: 31561998, DOI: 10.1016/j.annemergmed.2019.07.017.Peer-Reviewed Original ResearchConceptsQuality improvement interventionsHours of triageAntibiotic delaySeptic patientsImprovement interventionsAntibiotic requirementsLower Sequential Organ Failure Assessment scoresSequential Organ Failure Assessment scoreMedicaid Services Severe SepsisOrgan Failure Assessment scoreSurviving Sepsis Campaign recommendationsMost septic patientsOnset of hypoperfusionSurviving Sepsis CampaignAdult septic patientsQuality improvement databaseNational quality measuresMedicaid Services measuresTriage locationInfectious symptomsSevere sepsisChart reviewMost patientsSepsis CampaignPrimary outcomePlasma levels of F-actin and F:G-actin ratio as potential new biomarkers in patients with septic shock
Belsky JB, Morris DC, Bouchebl R, Filbin MR, Bobbitt KR, Jaehne AK, Rivers EP. Plasma levels of F-actin and F:G-actin ratio as potential new biomarkers in patients with septic shock. Biomarkers 2016, 21: 180-185. PMID: 26754286, DOI: 10.3109/1354750x.2015.1126646.Peer-Reviewed Original ResearchConceptsSystemic inflammatory response syndromeNoninfectious systemic inflammatory response syndromeSeptic shockThymosin beta 4Healthy controlsSIRS groupPlasma levelsInflammatory response syndromePotential new biomarkersResponse syndromeActin ratioNew biomarkersPotential biomarkersBeta 4PatientsBiomarkersActin levelsF-actinGroupSyndromeLevelsDiagnosis