In this systematic review, we found that hydrocortisone, ascorbic acid, and thiamine (HAT) regimen may be useful for reducing the duration of vasopressor use and improve organ functions in patients with sepsis and septic shock, although it was difficult to ascertain whether the addition of ascorbic acid and thiamine lead to more benefits compared to corticosteroids alone.

HAT regimen was also associated with increased LOS, which could be attributable to corticosteroid-associated side effects and/or the open-label designs of the included RCTs.

Future trials should continue to assess HAT regimen compared to corticosteroid comparators, and to differentiate between sepsis-specific mortality versus mortality from comorbidities and withdrawal of care.

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