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Master Thesis

Évaluation des pratiques de prescription de vitamine C chez les patients en choc septique en réanimation médicale au CHU de Rouen

Abstract : The medical intensive care unit at Rouen University Hospital has started using vitamin C in the treatment of septic shock since October 2017 after encouraging results in the literature on mortality and organ failure. But this use was not systematic. The aim of this study was to determine the factors influencing the prescription of vitamin C in patients with septic shock in intensive care units.
PATIENTS AND METHODS:
This was an observational, practice evaluation, retrospective, monocentric study in medical intensive care at Rouen University Hospital. The included patients have been hospitalized in the department between October 2017 and 2018 and were suffering from septic shock defined according to Sepsis-3 criteria. The introduction of vitamin C treatment was left up to the physician in charge of intensive care. The primary endpoint was the determination of factors associated with vitamin C prescription. Secondary endpoints included length of stay and resuscitation mortality, as well as the identification of organs failures.
RESULTS:
In our population of 68 patients, 39 patients were in the control group and 29 in the vitamin C group. Patients in the vitamin C group had a significantly higher SOFA score at admission (10.8 ± 3.7 vs. 8.3 ± 3.1 p = 0.004) and a higher IGS2 score (65.4 ± 12.9 vs. 52.9 ± 12.9 p = 0.002). The vitamin C group benefited more frequently from hydrocortisone (93.1% versus 25.6% p < 0.001). Treatment period and maximum dose of norepinephrine were also higher in the vitamin C group with a time of 71 days (34 - 97) versus 29 days (16 - 56.5) (p = 0.004) and a maximum dose of norepinephrine of 0.9 μg/kg/min (0.6 - 1.5) versus 0.2 μg/kg/min (0.1 - 0.6) (p < 0.001). Except for a longer intensive care stay in the vitamin C group of 11 days (4 - 14) versus 5 days (3 - 6) (p = 0.008), there was no significant difference on secondary endpoints.
CONCLUSION:
Vitamin C was used to treat patients in septic shock who are judged to be more severe at admission, with resistance to vasopressor drugs, in combination with hydrocortisone.
Document type :
Master Thesis
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Submitted on : Friday, May 28, 2021 - 12:20:58 PM
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Long-term archiving on: : Sunday, August 29, 2021 - 7:02:10 PM

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Maud Lambert. Évaluation des pratiques de prescription de vitamine C chez les patients en choc septique en réanimation médicale au CHU de Rouen. Médecine humaine et pathologie. 2020. ⟨dumas-03240831⟩

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