Answer: Paul Marik recently demonstrated the benefit of using a combination of high dose vitamin C, thiamine, and stress dose hydrocortisone in patients with sepsis. High dose vitamin C may cause renal oxalate crystallization. Thiamine (vitamin B1) prevents this crystallization.
The combination doses suggested are
- IV vitamin C - 1.5 g q 6 hours for four days or until ICU discharge
- IV thiamine - 200 mg q 12 hours for four days or until ICU discharge
- IV hydrocortisone - 50 mg q 6 hours for seven days or until ICU discharge