Baseline Participant Characteristics. M, Phillips
Total vasopressor doses was calculated as the sum of norepinephrine doses and converted doses of epinephrine and vasopressin. JAMA. This trial provided the intervention for a longer period (ie, up to 10 days) than the previous observational study, which assessed the effect of 4 days of therapy.13 This provided a sufficient treatment period for the intervention to have any potential effect. JA, Abner
Two decadesof mortality trends among patients with severe sepsis: A comparative meta-analysis. 2023 Apr;31(2):653-672. doi: 10.1007/s10787-023-01169-1. This trial was an open-label study; accordingly, all site personnel were aware of study interventions assigned to participants. SW, Wang
The magic cocktail contains vitamin C, thiamine and stress dose hydrocortisone. RD,
WebJanuary 2016 January 2020 Treated > 1500 septic patients admitted to MICU No exclusion criteria: HIV, Sickle disease, Kidney stone, ESRD, etc Reproducible clinical benefit No side effects Consulted on > 1000 patients' world wide Adopted by physicians & Hydrocortisone plus fludrocortisone for adults with septic shock. The full story is told in Dr. Kory's new book to be released June 6: "War on Ivermectin: The Medicine that Saved Millions & Could Have Ended the Pandemic" https://a.co/d/4VXS81g . doi: 10.1001/jama.2014.2637. K. Vitamin C and microvascular dysfunction in systemic inflammation. In this randomized clinical trial that included 216 patients with septic shock, treatment with intravenous vitamin C, hydrocortisone, and thiamine, compared with intravenous hydrocortisone alone, did not significantly improve the duration of time alive and free of vasopressor administration over 7 days (122.1 hours vs 124.6 hours, respectively). Through Dr. Marik's ground-breaking sepsis protocol. M, Deutschman
Dr Bellomo was supported by a Practitioner Fellowship from the National Health and Medical Research Council of Australia. The outcome was measured only in patients who were alive in the ICU on day 3, which was subject to the bias of competing risks in opposite directions, ie, early discharge from the ICU due to recovery or death. All Rights Reserved. The full story is told in Dr. Kory's new book to be released June 6: "War on Ivermectin: The Medicine that Saved Millions & Could Have Ended the Pandemic" https://a.co/d/4VXS81g .
MummyMobbs on Twitter: "RT @louisaclary: How did Dr. Pierre WebBackground: The global burden of sepsis is estimated as 15 to 19 million cases annually, with a mortality rate approaching 60% in low-income countries. But heres my biggest problem with using this therapy on my patients, we simply do not know if these therapies are truly benign, either alone or in combination. All other details of post hoc analyses are described in eAppendix 4 in Supplement 2. T, Belletti
Fisher
This randomized clinical trial compares the effects of high-dose vitamin C vs placebo on the incidence of organ failure and biomarkers of inflammation and vascular injury in patients in the intensive care unit (ICU) with sepsis and ARDS. Kaplan-Meier Analysis by Randomization Group, Figure 3. Dr. Marik of Sentara Norfolk General Hospital, Virginia, has been using the Marik protocol to treat sepsis in his ICU. B, Finfer
WHAT IS DR. MARIKS LIFE-SAVING PROTOCOL FOR TREATING "War on Ivermectin: The Medicine that Saved Millions & Could Have Ended the Pandemic" https://a.co/d/4VXS81g" RT @louisaclary: How did Dr. Pierre Kory & Dr. Paul Marik meet? Study protocol Open Access Published: 05 April 2019 The Vitamin C, Thiamine and Steroids in Sepsis (VICTAS) Protocol: a prospective, multi-center, double-blind, Unfortunately, most et al. Inflammopharmacology. Video used with permission. AM,
GS, Levy
This Medical News story examines the popularity of the Marik protocol, a combination of highdose vitamin C, corticosteroids, and thiamine to treat sepsis. Procurement of shared data instruments for Research Electronic Data Capture (REDCap). Patterns of Death in Patients with Sepsis and the Use of Hydrocortisone, Ascorbic Acid, and Thiamine to Prevent These Deaths. the patients had severe sepsis and were at risk of developing sepsis-related organ dysfunction.32-34 Patients < 18 years of age, pregnant patients, and patients with limitations of care were not treated with the vitamin C protocol. Whether this therapy eventually does turn out to be life saving (or whether it causes harm), we must remember that our primary job as clinicians is to administer therapies that have been vigorously proven by science and not simply based on parachute reasoning. Vitamin C and thiamine scavenge free radicals from superoxide (O. Fowler
Donnino
Chest. J,
If lactate elevated, can use normalization of lactate as resuscitation target. Sixth, this trial was underpowered to detect differences in mortality or other patient-centered outcomes as well as differences in outcomes among specific subgroups. No serious adverse events were reported. A, English
A fall greater than 30% over 72 hours usually indicates improved survival. et al; CRICS-TRIGGERSEP Network. is also trying the protocol. N, Tokuda
WebStep 1: Initial Resuscitation Early fluid resuscitation: start with 30mL/kg of crystalloid, typically ~2L. WebThrough Dr. Marik's ground-breaking sepsis protocol. I, Hayes
University of Maryland School of Medicine, Baltimore, MD WebStarter comment: after a few years of hype, and lots of early adopters, the first large RCT of vitamin C / thiamine / hydrocortisone in sepsis (the so-called Marik protocol) has landed with a resounding thud. If we have learned anything from our history, it is that even things that seem benign such as tight glycemic control can be harmful if not carefully looked at systematically. Medical News & Perspectives July 23, 2019 This Medical News story examines the popularity of the Marik protocol, a combination of highdose vitamin C, corticosteroids, and thiamine to treat sepsis. RitaRubin,MA PMC 8600 Rockville Pike Seventh, adverse events were reported only when treating clinicians adjudicated, and patients were not systematically examined for other possible adverse effects (eg, oxaluria) that might develop with high-dose IV vitamin C.28,29. Post hoc subgroup analysis for the primary outcome was performed on subgroups determined from baseline variables, which were lactate level, SOFA score, vasopressor dose, and hydrocortisone administration prior to enrollment. Patients admitted to a study intensive care unit (ICU) with a primary diagnosis of septic shock were screened for eligibility. V, Escobar
ML,
et al; ADRENAL Trial Investigators and the AustralianNew Zealand Intensive Care Society Clinical Trials Group. A, Courville
Through Dr. Marik's ground-breaking sepsis protocol. In this multicenter, international, open-label, randomized clinical trial of patients with septic shock, the combination of IV vitamin C, hydrocortisone, and thiamine compared with hydrocortisone alone did not significantly affect the time alive and free of vasopressor support up to day 7. III, Syed
S, Cohen
Correction: This article was corrected on February 28, 2020, for an author degree error. Outcomes of Metabolic Resuscitation Using Ascorbic Acid, Thiamine, and Glucocorticoids in the Early Treatment of Sepsis: The ORANGES Trial. It is unclear whether vitamin C, hydrocortisone, and thiamine are more effective than hydrocortisone alone in expediting resolution of septic shock. Ethical approval was obtained from local ethics committees for all study sites and from Monash University, Melbourne, Australia. Hospital deaths in patients with sepsis from 2 independent cohorts. Exclusion criteria included age younger than 18 years, a do-not-resuscitate order, imminent death, diagnosis of septic shock longer than 24 hours ago, known or suspected disease with a strong indication or contraindication for any of the study drugs, and another indication for hydrocortisone than septic shock. It's mostly dangerous Accepted for Publication: December 19, 2019.
Cheryl Ban on Twitter: "RT @louisaclary: How did Dr. Pierre Kory Cessation of vasopressor administration was defined as discontinuation of all vasopressor drugs for 4 consecutive hours in the presence of a mean arterial pressure greater than 65 mm Hg or achievement of a target mean arterial pressure set by the treating clinician. doi:10.1001/jama.2019.22176. Design, Setting, and Participants
Dr. Paul Mari k made headlines across the globe with a sepsis treatment he believes is saving lives, however he says he must lie low about the controversial treatment. Flow of Participants in the Vitamin C, Hydrocortisone, and Thiamine in Patients With Septic Shock (VITAMINS) Trial, Figure 2. All analyses were conducted in accordance with the published statistical analysis plan.16 Patient data were analyzed according to their randomization group, excluding those who withdrew consent. Furthermore, the other outcomes failed to support the observed beneficial effect. WebThe 6-hour sepsis protocol included a 2-liter fluid bolus administered within 1 hour of enrollment, followed by an additional 2-liter over the subsequent 4 hours (very similar to the SSC guideline). Fujii T, Luethi N, Young PJ, et al. Methods: the VITAMINS Trial Inclusion and Exclusion Criteria, eAppendix 2. The full story is told in Dr. Kory's new book to be released June 6: "War on Ivermectin: The Medicine that Saved Millions & Could Have Ended the Pandemic" https://a.co/d/4VXS81g . CS, Seymour
Torio C.M., Moore B.J. Full details are provided in eAppendix 4 in Supplement 2.
Hydrocortisone, Ascorbic Acid and Thiamine (HAT 2013 Feb; To determine whether the combination of vitamin C, hydrocortisone, and thiamine, compared with hydrocortisone alone, improves the duration of time alive and free of vasopressor administration in patients with septic shock. Keywords: Sepsis; vitamin C; HPA axis; stress response Submitted Nov 29, 2019. A,
Identification and experimental validation of mitochondria-related genes biomarkers associated with immune infiltration for sepsis. The finding suggests that treatment with intravenous vitamin C, hydrocortisone, and thiamine does not lead to a more rapid resolution of septic shock compared with intravenous hydrocortisone alone. Accessibility Statement, Our website uses cookies to enhance your experience. The management committee developed the trial protocol with a predefined statistical analysis plan (Supplement 1), which was published before study recruitment was completed.16. 2023 Mar 7;12(3):659. doi: 10.3390/antiox12030659. The recently completed HYPRESS trial did not demonstrate a benefit for steroids in patients with sepsis. All rights reserved. High-dose intravenous (IV) vitamin C has recently been explored as an adjunctive therapy in sepsis because of its anti-inflammatory and antioxidant properties.5-8 A previous randomized trial of 24 patients showed that high-dose IV vitamin C attenuated organ failure associated with sepsis in a dose-dependent manner.9 Thiamine deficiency has also been reported in 20% of critically ill patients with sepsis,10 and thiamine supplementation has been shown to improve lactate clearance in patients with sepsis.11,12 The combination of high-dose IV vitamin C and hydrocortisone together with thiamine was assessed in a single-center retrospective before-and-after study of 94 patients with severe sepsis or septic shock.13 The intervention was associated with shorter duration of vasopressor administration and lower hospital mortality.13 However, hydrocortisone alone has also consistently demonstrated efficacy in hastening the resolution of shock compared with placebo in 2 large multicenter double-blind trials.14,15 It is unclear whether the combination of vitamin C, hydrocortisone, and thiamine is more effective than hydrocortisone alone. Over 100 S,
There have been hundreds of studies trying to identify the holy grail to decrease mortality further, but one has not been found thus far. WebThrough Dr. Marik's ground-breaking sepsis protocol. The findings suggest that treatment with intravenous vitamin C, hydrocortisone, and thiamine does not lead to a more rapid resolution of septic shock compared with intravenous hydrocortisone alone. Blog:Keynotable. Furthermore, this trial was conducted at 10 sites, including both high- and middle-income countries.
Hydrocortisone, Vitamin C, and Thiamine for the et al. Called the EVMS protocol, it is based on Dr. Mariks safe, effective treatment protocol for sepsis the famous Marik Cocktail of intravenous Hydrocortisone, This trial also demonstrated that administration of vitamins in addition to hydrocortisone during the early phase of septic shock is feasible. Patients were randomized to the intervention group (n=109), consisting of intravenous vitamin C (1.5 g every 6 hours), hydrocortisone (50 mg every 6 hours), and thiamine (200 mg every 12 hours), or to the control group (n=107), consisting of intravenous hydrocortisone (50 mg every 6 hours) alone until shock resolution or up to 10 days. The Marik protocol for sepsis may save the life of one of your loved ones someday. J. Respir.
Silenced Survivor Vax Injured on Twitter: "RT @louisaclary: How Called the EVMS protocol, it is based on Dr. Mariks safe, effective treatment protocol for sepsis the famous Marik Cocktail of intravenous Hydrocortisone, Ascorbic Acid, and Thiamine (HAT).
Nicole's_in_AB on Twitter: "RT @louisaclary: How did Dr. Pierre EL, Kelly
The first patient was enrolled on May 8, 2018, and the last on July 9, 2019. Acquisition, analysis, or interpretation of data: Fujii, Luethi, Young, Frei, Eastwood, French, Deane, Shehabi, Hajjar, Oliveira, Udy, Orford, Hunt, Judd, Bitker, Cioccari, Naorungroj, Yanase, Bates, McGain, Hudson, Peppin, McCracken, Orosz, Bailey, Bellomo. We still need an external validation before implementation (How many other treatments in sepsis have been touted as a cure and not panned out in subsequent studies?). The full story is told in Dr. Kory's new book to be released June 6: "War on Ivermectin: The Medicine that Saved Millions & Could Have Ended the Pandemic" https://a.co/d/4VXS81g .
Sepsis Second, because of the study design, the possible individual effects of vitamin C and thiamine were not assessed separately. Effect estimates for mortality during any observation period point toward unfavorable effects in the intervention group; however, in light of having multiple secondary outcomes, all of which were underpowered, and the lack of evidence to support a harmful effect of the intervention, these findings should not be overinterpreted. DG. Among 216 patients who were randomized, 211 provided consent and completed the primary outcome measurement (mean age, 61.7 years [SD, 15.0]; 133 men [63%]). Haney Mallemat LW, Chase
Nicole's_in_AB on Twitter: "RT @louisaclary: How did Dr. Pierre Sepsis However, in the nested cohort study within the intervention group of this trial, the median plasma concentration of vitamin C increased from 28 mol/L at baseline to 369 mol/L 1 hour after the first dose and achieved nearly the same plasma level at 6 hours24 as reported in CITRIS-ALI at 48 hours.23 As there is limited knowledge regarding optimal target plasma vitamin C levels to achieve clinically significant outcomes, and as there was no consistent benefit on improving organ dysfunction or mortality across these randomized trials, uncertainty remains about how different dosing might modify these effects. National Inpatient Hospital Costs: The Most Expensive Conditions by Payer, 2013: Statistical Brief #240. Crit Care. T, Udy
Similarly, there was no statistically significant between-group difference in terms of 28-day cumulative vasopressor-free days, 28-day cumulative mechanical ventilationfree days, or 28-day cumulative renal replacement therapyfree days (Table 2). VITAMINS coordinating center (ANZIC-RC, Monash University): Michael Bailey, Tomoko Fujii, Belinda D. Howe, Nora Luethi, Lynnette Murray, Tony Trapani. Epub 2023 Feb 27. Question
This was the first study to evaluate the combination of intravenous vitamin C, hydrocortisone, and thiamine, Use of non-concurrent controls (i.e., patients were not evaluated during the same timeframe), PCT is not readily available at every hospital, No patients in the treatment group died from complications related to sepsis, rather their mortality was secondary to complications of their underlying disease, PCT typically decreases in a linear fashion in patients with severe sepsis (sepsis? et al. Marik
and septic shock patients and a procalcitonin (PCT) 2ng/mL: Treatment Group: Treated with standard sepsis care + intravenous vitamin C, hydrocortisone and thiamine within 24 hours of ICU admission. However, the level of statistical significance for 46 such secondary outcomes was not adjusted for multiple comparisons.23 Patients in the current study received lower daily doses of IV vitamin C compared with CITRIS-ALI. The difference of 25 hours was two-thirds of the effect estimate reported in the previous study13 and was considered plausible as a clinically minimally important difference (>1 day) for time alive and free of vasopressors. Care Med. Annane
All Rights Reserved, Challenges in Clinical Electrocardiography, Clinical Implications of Basic Neuroscience, Health Care Economics, Insurance, Payment, Scientific Discovery and the Future of Medicine, 2020;323(5):423-431. doi:10.1001/jama.2019.22176. et al. No other disclosures were reported. Obtained funding: Fujii, Luethi, French, Deane, Hajjar, Udy, Orosz, Bellomo. Web10.1007/s00134-016-4675-y Abstract Purpose: The optimal strategy of fluid resuscitation in the early hours of severe sepsis and septic shock is controversial, with both an aggressive and conservative approach being recommended. Dr Fujii was supported by the Japan Society for the Promotion of Science at the beginning of the trial. In brief, patients had suspected or documented infection with an acute increase of at least 2 points in the Sequential Organ Failure Assessment (SOFA) score,17 had a lactate level greater than 2 mmol/L, and were vasopressor dependent for at least 2 hours at the time of enrollment. The first patient was enrolled on May 8, 2018, and the last on July 9, 2019. The extended duration of the intervention might have increased separation between the 2 groups, potentially overestimating any effect size. 29 May 2023 22:36:13 E, Cocchi
Dr Udy was supported by the National Health and Medical Research Council of Australia (Early Career Fellowship GNT1124532). All diagnostic criteria for septic shock based on the Sepsis-3 consensus1 had to be fulfilled within a maximum of 24 hours prior to enrollment. Empiric broad spectrum antibiotics giving initially, which were de-escalated according to microbiological data and clinical progress, Conservative physiologic fluid based therapy, Lung protective strategy and avoidance of hyperoxia, Limited use of sedative agents (dexmedetomidine was the preferred agent), Norepinephrine was the vasopressor of choice (titrated to a dose of 20ug/min targeting a MAP >65mmHg), If needed, the next vasopressor added was vasopressin at 0.04 U/min, followed next with by phenylephrine or epinephrine, Enteral nutrition was initiated 24 hours after ICU admission and clinical stability achieved, DVT prophylaxis with enoxaparin (or heparin in patients with creatinine clearance <30ml/min) and sequential compression devices, Intravenous vitamin C 1.5g q6hr x4d or until ICU discharge, Hydrocortisone 50mg q6hr x7d or until ICU discharge followed by a taper over 3d, Intravenous thiamine 200mg q12hr x4 or until ICU discharge, Requirement for renal replacement therapy (RRT) in patients with AKI, Change in SOFA score over the first 72hours, Patients with limitations of care (DNR/Palliative), No difference in baseline characteristics between groups. Archives of Neurology & Psychiatry (1919-1959), JAMAevidence: The Rational Clinical Examination, JAMAevidence: Users' Guides to the Medical Literature, JAMA Surgery Guide to Statistics and Methods, Antiretroviral Drugs for HIV Treatment and Prevention in Adults - 2022 IAS-USA Recommendations, CONSERVE 2021 Guidelines for Reporting Trials Modified for the COVID-19 Pandemic, Global Burden of Skin Diseases, 1990-2017, Guidelines for Reporting Outcomes in Trial Protocols: The SPIRIT-Outcomes 2022 Extension, Mass Violence and the Complex Spectrum of Mental Illness and Mental Functioning, Organization and Performance of US Health Systems, Spirituality in Serious Illness and Health, The US Medicaid Program: Coverage, Financing, Reforms, and Implications for Health Equity, Screening for Prediabetes and Type 2 Diabetes, Statins for Primary Prevention of Cardiovascular Disease, Vitamin and Mineral Supplements for Primary Prevention of of Cardiovascular Disease and Cancer, Statement on Potentially Offensive Content, Register for email alerts with links to free full-text articles. Dr. Marik said the response by patients physicians has been about half and half, with some willing to try, and the other half saying its complete and utter nonsense. AA, Deane
-, Gaieski D.F., Edwards J.M., Kallan M.J., Carr B.G. The final date of follow-up was October 6, 2019. Administrative, technical, or material support: Fujii, Luethi, Young, Frei, Eastwood, Hajjar, Udy, Orford, Bitker, Bates, McGain, Al-Bassam, Peppin, Bellomo.
sepsis The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). These Hospitals Arent Waiting for Proof, SGEM#174 Dont Believe the Hype Vitamin C Cocktail for Sepsis, https://rebelem.com/the-marik-protocol-have-we-found-a-cure-for-severe-sepsis-and-septic-shock/, Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License, Electronic Heath Record (EHR) retrospective before-after clinical study. WebWorld-renowned critical care specialist Dr. Paul Marik outlines his life-saving, cheap, and safe protocol for treating sepsis in the hospital, the leading cause of death in the world.
Has Sepsis met its match? | EVMS Magazine 9.4 There was no significant difference between groups for death (intervention, 15.9%, vs control, 14.4%; P=.77) or vasopressor redependence (intervention, 33.3%, vs control, 26.7%; P=.33) by day 7. "The Marik Protocol: Have We Found a Cure for Severe Sepsis and Septic Shock? 2022 Dec 14;4(12):e0823. If a patient died before consent to continue could be obtained from the patient or the legal surrogate, the patients data were included if the relevant ethics committee approved this. S,
Silenced Survivor Vax Injured on Twitter: "RT @louisaclary: How Assessment of global incidence and mortality of hospital-treated sepsis: current estimates and limitations. The primary trial outcome was duration of time alive and free of vasopressor administration up to day 7. Twitter: @criticalcarenow Vitamin C, Hydrocortisone, and Thiamine vs Hydrocortisone Alone and Outcomes in Septic Shock, Figure 1. et al. Results
The maximum stage of acute kidney injury during the first 7 days after randomization (Table 2) and the vasopressor dose during the first 10 days were not significantly different between the 2 groups (ratio of geometric means for intervention vs control, 0.93; 95% CI, 0.65-1.32; P=.65) (Figure 3). Because previous studies have suggested that both vitamin C9 and thiamine10-12 might be beneficial for patients with septic shock and an observational study reported decreased mortality associated with combination therapy,13 research priority was allocated to examining the beneficial effect of the vitamins and hydrocortisone combination over evaluating the effect of each component.13 The effects of each vitamin and the combination are to be assessed in a network meta-analysis, which will inform future trials of promising components or combinations of the intervention.27. Main Outcomes and Measures
In fact, Marik himself has made the claim that withholding this therapy while waiting for a multicenter trial to be completed would be unethical. Ninety-day mortality was 30/105 (28.6%) in the intervention group and 25/102 (24.5%) in the control group (hazard ratio, 1.18; 95% CI, 0.69-2.00). First, the trial was open label in design and lacked blinded outcome assessment, thus creating the possibility of performance and ascertainment bias. Ten secondary outcomes were prespecified, including 90-day mortality. Sepsis is a devastating disease that carries an enormous toll in terms of human suffering and lives lost. Accessibility WebRead the entire Marik sepsis protocol. The full story is told in Dr. Kory's new book to be released June 6: "War on Ivermectin: The Medicine that Saved HHS Vulnerability Disclosure, Help This is not a new concept and there are studies demonstrating benefit so perhaps, combining all these harmless therapies would work on the deranged physiologic pathways that are present in the septic patient. CW,
Noncoding RNA. Schulz
In this randomized clinical trial that included 216 patients with septic shock, treatment with intravenous vitamin C, hydrocortisone, and thiamine, compared with intravenous hydrocortisone alone, did not significantly improve the duration of time alive and free of vasopressor administration over 7 days (122.1 hours vs 124.6 hours, respectively). JAMA. WebMachine learning algorithms are the most accurate way to identify sepsis, with an average 81% sensitivity and 72% specificity. Detailed results of protocol adherence are reported in eAppendix 5 in Supplement 2. Interventions
There have been many exciting clinical trials for critically ill patients over the years (e.g., Early Goal Directed Therapy, tight glycemic control, etc.). Multivariable sensitivity analysis using quantile regression adjusting for site and baseline imbalance (APACHE III score, lactate levels, white blood cell counts, and use of milrinone) confirmed the robustness of the effect estimates in the primary analysis (median of differences, 4.6 hours; 95% CI, 15.7 to 6.5 hours; P=.41). The SOFA (Sepsis-Related Organ Failure Assessment) score to describe organ dysfunction/failure. doi: 10.1164/rccm.201504-0781OC. Accepted for publication Dec 02, 2019. doi: 10.21037/jtd.2019.12.64 If a patient died while receiving vasopressor therapy following the index episode of septic shock, the patient was assigned zero hours for this outcome. [Edit: full protocol] IV Vitamin C (1.5 Through Dr. Marik's ground-breaking sepsis protocol. Ragoonanan D, Tran N, Modi V, Morgan Nickelsen P. Am J Health Syst Pharm.
Hydrocortisone, Vitamin C, and Thiamine for the Treatment of Dr. Paul E. Marik proclaims end Overall incidence of death was not significantly different between the groups (log-rank P=.55). Fifth, time to the administration of antibiotics was not collected; however, all patients had already received antibiotics at enrollment. Careers. Marik PE et al [1] published a study in Chest 2016 that has found a potential front runner. Drafting of the manuscript: Fujii, Luethi, Young, Eastwood, Deane, Shehabi, Hajjar, Udy, Al-Bassam, Peppin, Orosz, Bellomo. One hundred seven patients in the intervention group and 104 patients in the control group were included in the analysis for the primary outcome (Figure 1). Before WebThrough Dr. Marik's ground-breaking sepsis protocol. LN, Rahim
Through Dr. Marik's ground-breaking sepsis protocol. The robustness of the sample size estimation was further confirmed with the same method after recruitment of 108 patients (Supplement 3). 2018 Nov/Dec;19(8):812-820. doi: 10.1089/sur.2018.111. Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.