Clinical Protocol and Participant

This research was conducted after obtaining informed consent and approval from the University of North Sumatra Medical Faculty Research Ethics Committee and permission from the Education and Training Division of Adam Malik Hospital, Medan. All patients were diagnosed with sepsis using qSOFA criteria or SOFA score according to the Surviving Sepsis Guidelines. Patients, including the sample, were performed a physical examination and treated with an hour-1 sepsis bundle, then managed other supporting sepsis therapies according to our standard operating procedures such as source control of infection. Samples included in the inclusion criteria were randomized using a computer and divided into four groups: the normal saline group, thiamine, ascorbic acid, and both (a combination of thiamine and ascorbate). The normal saline group got 0.9% NaCl 50 cc (drip 60 minutes every 12 hours) for three days. The thiamine group received a 200 mg thiamine injection administered (drip 60 minutes every 12 hours) for three days. The ascorbic acid group received an ascorbic acid injection of 50 mg/kg BW administered (60 minutes every 12 hours) for three days. The combination group received a thiamine injection of 200 mg and an ascorbic acid injection of 50 mg/kg BW administered (60 minutes every 12 hours) for three days. Drugs were prepared and administered by the research assistant. The MMP-9 and TIMP-1 examination (ELISA kit, Antibody-Sunlong Biotech Co., Ltd) was carried out before intervention. Second blood draw for the levels of MMP-9 and TIMP-1 check after the intervention about 72 hours.