Study Procedures
delirium, death, Confusion
Details of the VICTAS trial protocol and analysis have been reported.The intervention consisted of intravenous vitamin C (1.5 g), thiamine hydrochloride (100 mg), and hydrocortisone sodium succinate (50 mg) administered within 4 hours of randomization and every 6 hours thereafter for up to 96 hours or until death or ICU discharge (whichever occurred first). Participants in the control group received placebo injections of normal saline matched by volume at the same frequency. Participants could be treated with open-label corticosteroids as deemed appropriate by the clinicians; in cases of daily doses greater than or equal to 200 mg of hydrocortisone (or equivalent), investigational hydrocortisone or matching placebo was withheld by the pharmacy. Trained research personnel assessed participants for delirium daily during the intervention period using the Confusion Assessment Method for the ICU in conjunction with the Richmond Agitation-Sedation Scale. All other clinical management of participants, including enteral vitamin supplementation and nutrition, was at the discretion of the clinicians.