High-Dose Intravenous Vitamin C and Thiamine as Adjunct Therapy for Septic Shock in the Pediatric ICU: A Case Report

Pediatric sepsis and septic shock continue to be a life-threatening medical condition worldwide. Over the past decades, there has been a focus on the early identification and treatment of sepsis primarily with bundled and goal directed therapy. Despite these advances, morbidity and mortality have remained high, prompting investigation into novel therapies. High-dose vitamin C, thiamine and hydrocortisone (triple therapy) have been studied to be beneficial in the adult population with septic shock. However, there is a lack of evidence supporting this triple therapy in pediatric patients. This patient case presents an adult patient by age with a weight similar to that of an elevenyear- old boy in septic shock. After four days of receiving triple therapy, the vasopressor was weaned off and septic shock resolved. Based on our outcomes, this case report warrants the need for future studies investigating the use of high-dose vitamin C, thiamine and hydrocortisone as therapeutic options for sepsis or septic shock in the vulnerable pediatric population. Keywords: Ascorbic acid; High-dose Vitamin C; Pediatric; Sepsis; Septic shock