Hydrocortisone, ascorbic acid, and thiamine (HAT) for sepsis and septic shock: a meta-analysis with sequential trial analysis

• DOI: 10.1186/s40560-021-00589-x
• Publication Date: 2021-12-18T11:14:26Z
• Authors: Weilan Na; Huili Shen; Yichu Li; Dong Qu
• Keywords: Subgroup analysis; SOFA score

Abstract Background Sepsis is a primary global health threat and costs lot, requiring effective affordable treatments. We performed this meta-analysis to explore the treatment of hydrocortisone, ascorbic acid, thiamine (HAT) in sepsis septic shock. Methods searched Ovid MEDLINE, Embase, Cochrane Central Register Controlled Trials from inception August 14, 2021. included randomized controlled trials (RCTs) that evaluated HAT treatments The outcome was change SOFA score over 72 h. second outcomes were hospital, 28-/30-day mortality, duration vasopressors, PCT clearance, hospital length stay (LOS), ICU LOS. subgroup analysis trial sequential (TSA). Der Simonian–Laird random-effects models used report pooled risk ratios (RR) or mean difference (MD) with confidence intervals (CI). Results Nine RCTs, enrolling 1427 patients shock treated (717) only standard care (710), included. There significant between two groups first h (MD 0.65, 95% CI 0.30 1.00), vasopressors − 18.16, 25.65 10.68) clearance 14.54, 0.64 28.43). In addition, there no mortality (RR 1.07, 0.85 1.34), 0.96, 0.80 1.15), LOS 0.78, 1.86), 0.12, 0.53 0.78). Conclusions combination improves reduces sepsis. Given minor score, benefit has not been observed. Trial registration PROSPERO, CRD42020203166.