Utilidad del ácido ascórbico, complejo B y corticoesteroides en el manejo convencional de la sepsis y choque según factores de riesgo
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2021
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
Antecedentes: La terapia complementaria para sepsis con ácido ascórbico, vitamina B1
e hidrocortisona ha sido una propuesta que no se ha implementado de manera
sistemática debido a los resultados contradictorios de los estudios. Objetivo:
Determinar la utilidad del tratamiento con una combinación de ácido ascórbico,
complejo B y corticoesteroides frente al manejo convencional para el manejo de la
sepsis/choque séptico, en pacientes según factores de riesgo. Metodología: En los
hospitales del grupo Clínica Kennedy en Guayaquil-Ecuador se realizó un estudio de
cohorte que incluyó de manera no aleatoria pacientes con diagnóstico de sepsis/choque
séptico entre el 1-04-2019 hasta el 31-03-2020 a los que se administró terapia
complementaria (ácido ascórbico, complejo B, hidrocortisona) (n= 34) o convencional
(n= 41). Resultados: el tratamiento convencional + complementario y tratamiento
complementario son parecidas en las puntuaciones de APACHE (13 ± 8 vs 13 ± 7; p
0.953), SOFA (6 ± 3 vs. 6 ± 4; p 0.975), PCR (126 ± 61 vs. 118 ± 51; 0,573) al 4to
día. Con el tratamiento complementario se consiguió diferencias entre el ingreso y el
4to día en puntuaciones de APACHE (16 ± 7 vs 13 ± 7; p 0.016) y PCR (72 ± 62 vs.
114 ± 50; 0,002) no en SOFA (p 0.815). Con el complementario no se obtuvo
diferencias estadísticas en APACHE (p 0.880), SOFA (p 0.642), PCR (0,176)
Conclusión: Se observan igual beneficios del tratamiento complementario al
tratamiento convencional en el manejo de la sepsis/choque séptico.
Background: Complementary therapy for sepsis with ascorbic acid, vitamin B1, and hydrocortisone has been a proposal that has not been systematically implemented due to conflicting study results. To determine the usefulness of treatment with a combination of ascorbic acid, B complex and corticosteroids compared to conventional management for the management of sepsis / septic shock, in patients according to risk factors. Methodology: In the hospitals of the Kennedy Clinic Group from Guayaquil-Ecuador, a cohort study was carried out that non-randomly included patients with a diagnosis of sepsis / septic shock between April 1, 2019 and March 31, 2020. Complementary therapy (ascorbic acid, B complex, hydrocortisone) (n = 34) or conventional (n = 41) was administered. Results: conventional treatment + complementary and complementary treatment are similar in APACHE scores (13 ± 8 vs 13 ± 7; p 0.953), SOFA (6 ± 3 vs. 6 ± 4; p 0.975), CRP (126 ± 61 vs. 118 ± 51; 0.573) on the 4th day. With the complementary treatment, differences were achieved between admission and the 4th day in APACHE scores (16 ± 7 vs 13 ± 7; p 0.016) and CRP (72 ± 62 vs. 114 ± 50; 0.002) not in SOFA (p 0.815). With the complementary treatment, no statistical differences were obtained in APACHE (p 0.880), SOFA (p 0.642), and CRP (0.176). Conclusion: The same benefits are observed from complementary treatment to conventional treatment in the management of sepsis / septic shock
Background: Complementary therapy for sepsis with ascorbic acid, vitamin B1, and hydrocortisone has been a proposal that has not been systematically implemented due to conflicting study results. To determine the usefulness of treatment with a combination of ascorbic acid, B complex and corticosteroids compared to conventional management for the management of sepsis / septic shock, in patients according to risk factors. Methodology: In the hospitals of the Kennedy Clinic Group from Guayaquil-Ecuador, a cohort study was carried out that non-randomly included patients with a diagnosis of sepsis / septic shock between April 1, 2019 and March 31, 2020. Complementary therapy (ascorbic acid, B complex, hydrocortisone) (n = 34) or conventional (n = 41) was administered. Results: conventional treatment + complementary and complementary treatment are similar in APACHE scores (13 ± 8 vs 13 ± 7; p 0.953), SOFA (6 ± 3 vs. 6 ± 4; p 0.975), CRP (126 ± 61 vs. 118 ± 51; 0.573) on the 4th day. With the complementary treatment, differences were achieved between admission and the 4th day in APACHE scores (16 ± 7 vs 13 ± 7; p 0.016) and CRP (72 ± 62 vs. 114 ± 50; 0.002) not in SOFA (p 0.815). With the complementary treatment, no statistical differences were obtained in APACHE (p 0.880), SOFA (p 0.642), and CRP (0.176). Conclusion: The same benefits are observed from complementary treatment to conventional treatment in the management of sepsis / septic shock
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ACIDO ASCORBICO, COMPLEJO B, CORTICOSTEROIDES, SEPSIS, CHOQUE SEPTICO, FACTORES DE RIESGO, HOSPITAL CLINICA KENNEDY, CANTON GUAYAQUIL, ECUADOR