Patients in Norfolk with severe Sepsis were treated with intravenous vitamin C, hydrocortisone and thiamine. In 47 patients with sepsis treated in Norfolk General’s ICU, four died in 2016, an 8 percent mortality rate. Of those four, none died of sepsis but rather the conditions that led to sepsis in the first place. The previous year, 19 of 47 septic patients died, a 40 percent mortality rate. They have written up the study in the Journal Chest.
Doctor Marik wants there to be a comprehensive study, and he said that Stanford University has expressed some interest. But he said it will be difficult to fund because it uses drugs that have been on the market for decades: “We are curing it for $60. No one will make any money off it.”
Sepsis occurs in more than 1 million people a year in this country, with 28 to 50 percent dying, according to the National Institutes of Health.
The condition can stem from a variety of different ailments and has an overwhelming immune response to infection. Natural chemicals released in the body trigger widespread inflammation, which leads to blood clots and leaky vessels. That slows blood flow, damaging the organs by depriving them of nutrients and oxygen.
In the worst cases, blood pressure drops, the heart weakens and the patient goes into septic shock.
The cost to treat sepsis in the United States has been estimated at $20 billion a year in 2011.
Just as Marik pulled Vitamin C out of his bag to save the woman in January 2016, he pulls out these facts to sell his sepsis treatment to others.
He believes lives could be saved before a larger study is complete. He’s been traveling the country trying to find audiences of critical-care doctors to peddle the idea – Philadelphia, Charlottesville, Long Island, New York and, earlier this week, Seattle.
He’s gotten significant pushback from doctors who say it’s unethical to try before larger studies are done. But he responds that the use is within the limits of what the Vitamin C pharmaceutical label recommends.
“Half think it’s cool and half think this is hooey nonsense. When something is too good to be true, people don’t want to believe it.”
Carlbom said since sepsis results from a lot of different conditions, it could be that the combo could help some more than others, and might even be detrimental to particular ailments.
Dr. Marik, who was born and educated in South Africa, is hardly a lightweight in the field. He has more than two decades of critical-care experience and has authored 400 medical journal articles and four books on critical care.
Lab work also confirms the result
Marik also took the step of having a researcher examine the idea in the lab. He reached out to John Catravas, who studies and teaches on the subject of bioelectrics at Old Dominion University.
Catravas has spent years researching lung function. Of special interest are the lung’s endothelial cells, which form the linings of the blood vessels: “When you have sepsis, the endothelial cells pull away from each other and allow fluid in the lungs.”
He looked at the effect of the Vitamin C, then the steroid, then the two in combination.
It wasn’t one or the other that was doing the trick, but both, almost as though one was holding the door open for the other to do its work in reducing inflammation.
It was a laboratory finding that supported what was happening in the clinical setting, which Marik included in the CHEST publication.
The global burden of sepsis is estimated as 15 to 19 million cases annually with a mortality rate approaching 60% in low income countries.
In this retrospective before-after clinical study, we compared the outcome and clinical course of consecutive septic patients treated with intravenous vitamin C, hydrocortisone and thiamine during a 7-month period (treatment group) compared to a control group treated in our ICU during the preceding 7 months. The primary outcome was hospital survival. A propensity score was generated to adjust the primary outcome.
There were 47 patients in both treatment and control groups with no significant differences in baseline characteristics between the two groups. The hospital mortality was 8.5% (4 of 47) in the treatment group compared to 40.4% (19 of 47) in the control group. The propensity adjusted odds of mortality in the patients treated with the vitamin C protocol was 0.13. The SOFA score decreased in all patients in the treatment group with none developing progressive organ failure. Vasopressors were weaned off all patients in the treatment group, a mean of 18.3 ± 9.8 hours after starting treatment with vitamin C protocol. The mean duration of vasopressor use was 54.9 ± 28.4 hours in the control group.
Our results suggest that the early use of intravenous vitamin C, together with corticosteroids and thiamine may prove to be effective in preventing progressive organ dysfunction including acute kidney injury and reducing the mortality of patients with severe sepsis and septic shock. Additional studies are required to confirm these preliminary findings.