Intervention
septic shock
SEPTIC SHOCK
Patients in the NaAscorbate group received 30 g of NaAscorbate Solution (30 g in 100 ml, Biological Therapies, Melbourne, Australia) diluted in 150 ml 5% glucose solution over 1 h followed by a further 30 g diluted with 150 ml 5% glucose over 5 h (60 g over 6 h in total). Patients in the control group received a fluid volume-matched 5% glucose solution (vehicle), administered over 1 h followed by 250 ml 5% glucose over 5 h. Research staff who were independent from clinical care prepared the study drug. The study drug was identical and labelled as “Vitamin C 30 g or Placebo in 250 ml 5% glucose”. The study drug (NaAscorbate or placebo) was infused via a central venous catheter. All research data were extracted from electronic medical record (EMR) system by the research staff. All EMR data were entered by bedside nurses or doctors who did not know study allocation. Also, the laboratory team who measured all biomarkers and/or NaAscorbate levels were blinded to treatment allocation.We collected arterial blood gas data at baseline, one, four and six h after commencement of the infusion. If the blood gas sodium value increased more than 10 mmol/L from the baseline or to an absolute sodium value > 160 mmol/L, the study drug was immediately ceased. This threshold was amended from the initial protocol to a change of > 7 mmol/L or an absolute Na value > 155 mmol/L from the 13th patient. All other aspects of septic shock treatment were dictated by the treating ICU specialists.