Miracle Cure for Sepsis

gonefishing said:
Anyone have any thoughts on this?
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Interesting. It definitely seems worth a double blind trial. It's seemingly on the lower side cost-wise. I like that it's such a simplistic and straightforward approach, especially in a day and age where we seem to be running out of antibiotics to throw at patients.

That said, who know what sort of resistance will be met from profit driven pharmaceutical companies; it's an unfortunate reality. He's already being met with skepticism by his peers, which by no means discounts his efforts or idea, IMHO.
gonefishing said:
Maybe the way of the future?
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As stated above, it's just way too early to tell, but certainly a refreshingly cost-effective and practical approach. I'd like to see it pick up steam with intensivists throughout the nation.
 
VentMonkey said:
Interesting. It definitely seems worth a double blind trial. It's seemingly on the lower side cost-wise. I like that it's such a simplistic and straightforward approach, especially in a day and age where we seem to be running out of antibiotics to throw at patients.

That said, who know what sort of resistance will be met from profit driven pharmaceutical companies; it's an unfortunate reality. He's already being met with skepticism by his peers, which by no means discounts his efforts or idea, IMHO.

As stated above, it's just way too early to tell, but certainly a refreshingly cost-effective and practical approach. I'd like to see it pick up steam with intensivists throughout the nation.
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But as you stated in a way and how the doctor put it, a $60 cure no money to be made. Big Pharma wouldn't like it.

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VentMonkey said:
That said, who know what sort of resistance will be met from profit driven pharmaceutical companies; it's an unfortunate reality. He's already being met with skepticism by his peers, which by no means discounts his efforts or idea, IMHO.
.
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There are lots of ways to get money for a study like the one they'd need to do that don't involve pharmaceutical companies. They could find funding if they were convinced it was real. That big pharma excuse is kind of a canard.

Let's see a large, double blinded, RCT then we'll see.
 
This is honestly the sort of study that doesn't need any funding. All the drugs are on formulary at every hospital's pharmacy already, and ready to be ordered. As long as it is done in a somewhat non-incompetent center, the hospital can randomize the study drug or placebo to sealed envelopes and stats could be done by a PI or resident or someone who needs their name on a paper.
 
Really interesting findings. I actually got a copy of the study paper last night and read it. Surprisingly, the key to this whole thing is the vitamin C and the steroids concurrently. Most interesting is out of the 47 patients in the control group none of them died from sepsis, they died of the comorbidities that lead to them arriving in the hospital the first time. The paper is fascinating. And by the way, drugs are not extremely high dose, vitamin c is only 6 g broken into 1.5 g doses throughout the day and the serous is. 50mg push of hydrocortisone. The entire protocol is available for review.
 
Here is the journal citation for anyone looking to read the paper.

Hydrocortisone, Vitamin C and Thiamine for the Treatment of Severe Sepsis and Septic Shock: A Retrospective Before-After Study
Paul E. Marik, MD, FCCM, FCCP; Vikramjit Khangoora, MD; Racquel Rivera, Pharm D; Michael H. Hooper, M.D., MSc; John Catravas, PhD, FAHA, FCCP
Chest. 2016. doi:10.1016/j.chest.2016.11.036

I will have to wait until work tomorrow with my institutional access before I can read the full text of it.
 
Interesting. Agreed, lets see more

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VentMonkey said:
Such as? Remember, I'm an out-of-hospital provider, as are many on this forum. By all means, enlighten us.
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For starters:
https://www.nimh.nih.gov/funding/index.shtml

There's vast areas of research that don't involve drugs or devices that manage to do valid, relevant research.

BTW, the question of steroids is sepsis has been around for a while and has been a point of contention among CC specialists. Steroids are pretty cheap and there's been tons of research on their use in sepsis. Here's a decent summary:

http://www.sccm.org/Communications/...s/Use-of-Corticosteroids-in-Septic-Shock.aspx

By the way, Vent, since when did being an out of hospital provider pose any disadvantage to understanding medical issues of the day? I have to say that this forum is one of the most lively, diverse and informed out here. Folks come from all over and are headed in all kinds of directions. I've yet to find a more interesting place to waste time on a medical forum.
 
E tank said:
By the way, Vent, since when did being an out of hospital provider pose any disadvantage to understanding medical issues of the day?
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Slow your roll. I never said it did. The question I posted was from the viewpoint of just that. A provider who doesn't deal with hospital politics, doctors, mid-levels, or even pharmaceutical reps to the point where I would begin to try and understand how or why a money-making giant such as a pharmaceutical company wouldn't whisper sweet nothings in the ears of many of this docs colleagues in complete opposition of a seemingly more cost-effective, practical, and simplistic approach.

Again, rendering whatever drug they want to muster up to fight the next "superbug" because natural medicine "doesn't quite work". Diverse, right? So that means opening dialogue, and helping to enlighten myself and my prehospital peers, which is what I did. So thanks, tank... I guess?:confused:
 
VentMonkey said:
Slow your roll. I never said it did. The question I posted was from the viewpoint of just that. A provider who doesn't deal with hospital politics, doctors, mid-levels, or even pharmaceutical reps to the point where I would begin to try and understand how or why a money-making giant such as a pharmaceutical company wouldn't whisper sweet nothings in the ears of many of this docs colleagues in complete opposition of a seemingly more cost-effective, practical, and simplistic approach.

Again, rendering whatever drug they want to muster up to fight the next "superbug" because natural medicine "doesn't quite work". Diverse, right? So that means opening dialogue, and helping to enlighten myself and my prehospital peers, which is what I did. So thanks, tank... I guess?:confused:
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Fair enough, Bro, just came across as being unduly unfair to yourself...point taken. On the other point, I'm not such the Polly Anna to think big pharm is as pure as the wind driven snow, but that they make A LOT of money doing what they do isn't a hard lock that they, across the board, have no interest in helping find more effective ways in treating problems like sepsis, or at least not being obstructive. After all, it is the patients that survive that require more medical treatment, not the dead ones.
 
@E tank no hard feels here:). I just can't imagine he won't have an uphill battle on his hands; all innovative leaders seem to in one way, or another. Personally, I'm a fan of certain aspects of holistic medicine, and find some western ways, and/ or approaches blindly arrogant at times.

I don't know that this is quite holistic, but it certainly seems like a refreshing change from jamming the latest medicine into these patient and further dampening their immune systems; it's essentially, vitamins, so yes I would love to see a huge RCT and its end result.

Clearly his approach seems "too good to be true" to some as cited in the EMS 1 article, but to me it's sad that it's not yet being embraced, or adopted quite as rapidly in the CC world by intensivists.

It doesn't seem all that harmful, or costly, so I'm just curious as to what people would have to be so cautious about.
 
VentMonkey said:
@E tank It doesn't seem all that harmful, or costly, so I'm just curious as to what people would have to be so cautious about.
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A big part of the problem is controlling for the huge number of variables that go into surviving and dying from sepsis. Designing a study with as few flaws as possible here would be incredibly difficult. I think that coming up with a useful, defendable question and answer is a bigger problem than coming up with the money. It can be done, but not in one study.
 
E tank said:
A big part of the problem is controlling for the huge number of variables that go into surviving and dying from sepsis. Designing a study with as few flaws as possible here would be incredibly difficult. I think that coming up with a useful, defendable question and answer is a bigger problem than coming up with the money. It can be done, but not in one study.
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So yeah, thanks. This is the kind of stuff I have zero clue about. A diverse forum indeed, but it certainly helps when higher-level providers share their insight. Aside from stat-driven, economics majors (ahem, @EpiEMS:D), it isn't all too common that we get to hear from the other side of the fence.

I'm not insulting or devaluing our intelligence as providers by any means, merely trying to employ a culture of shared knowledge, and in turn, knowledge-based growth.

#BackOnTheTrainTracksChooChoo
 
I had to check if it's April 1st yet after reading this article.
Is this dude a friend of Dr Oz?
Or maybe he is friends with Donald Trump's physician, you know the one who tells us that Trump is "the healthiest man ever to run for the office of president " and that all his tests were "positive"
Just the fact that this guy uses the word "ginormous" when speaking to a reporter should make you wonder if this is not in fact an April fools joke.
Always remember that there are a large number of weirdos and hacks who are doctors
 
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