Intravenous Vitamin C in Adults with Sepsis in the Intensive Care Unit

[TheLoneWolf]

https://www.nejm.org/doi/full/10.1056/NEJMoa2200644

In direct opposition to Marik's position a few years ago. Interesting to see it actually increased mortality and persistent organ dysfunction.

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[Beeftenderloin]

Marik’s original “metabolic resuscitation” study that boasted a preposterous absolute mortality benefit north of 30% in sepsis patients relied on fraudulent, falsified data. The man is a disgrace.

He was a quack ivermectin pusher and was quietly forced to resign from his position as head of pulm CC at Eastern Virginia Medical School related to a lawsuit he waged against the hospital for not allowing him to hurt patients with ivermectin.

I looked up to this guy and read a lot of his stuff early in training. Unfortunately he turned out to be a total crook and snake oil salesman. All the validation studies taking a second look at his protocol were a total waste of time, money and effort.

Color me shocked.

 

[coffeebythelake]

Marik is a quack
But he isn't alone
Lots of quackery out there touted by ccm/em big whigs
Rivers probably touting quackery too.

 

[Ronin786]

Marik’s original “metabolic resuscitation” study that boasted a preposterous absolute mortality benefit north of 30% in sepsis patients relied on fraudulent, falsified data. The man is a disgrace.

He was a quack ivermectin pusher and was quietly forced to resign from his position as head of pulm CC at Eastern Virginia Medical School related to a lawsuit he waged against the hospital for not allowing him to hurt patients with ivermectin.

I looked up to this guy and read a lot of his stuff early in training. Unfortunately he turned out to be a total crook and snake oil salesman. All the validation studies taking a second look at his protocol were a total waste of time, money and effort.

Color me shocked.

It is quite sad because a lot of his work about fluid deresuscitation, CVP and the fallacies of invasive/non-invasive cardiac output monitors is valuable. Unfortunately, you could tell he was a schill when he tore ClearSight to the ground then propped up Cheetah instead.

 

[narcusprince]

Americas front line physician…… not surprised that Marick was a quack….. look at his history….. and his patient population…… I have some independent theories about Marick.

 

[cchoukal]

It is quite sad because a lot of his work about fluid deresuscitation, CVP and the fallacies of invasive/non-invasive cardiac output monitors is valuable. Unfortunately, you could tell he was a schill when he tore ClearSight to the ground then propped up Cheetah instead.

I was recently in a discussion with a colleague about the pendulum-swinging of starting perioperative beta-blockade in naive patients with risk factors (as opposed to continuing them in patients already on them), and how the preponderance of high quality data supporting this practice was done by someone who was ultimately defrocked and fired for academic dishonesty; ultimately, it seems most of the remaining data trends toward harm.

So now we have a culture where everyone ****s all over the CVP as a measure of fluid responsiveness (myself included), largely based on Marek's two meta-analyses. Does his charlatanism invalidate his assertions on CVP vs dynamic respiratory indices (e.g., pulse-pressure variation)?

 

[Beeftenderloin]

I was recently in a discussion with a colleague about the pendulum-swinging of starting perioperative beta-blockade in naive patients with risk factors (as opposed to continuing them in patients already on them), and how the preponderance of high quality data supporting this practice was done by someone who was ultimately defrocked and fired for academic dishonesty; ultimately, it seems most of the remaining data trends toward harm.

So now we have a culture where everyone ****s all over the CVP as a measure of fluid responsiveness (myself included), largely based on Marek's two meta-analyses. Does his charlatanism invalidate his assertions on CVP vs dynamic respiratory indices (e.g., pulse-pressure variation)?

I’ve read his CVP work, and even presented it in talks.

Marik was a self-proclaimed iconoclast. Constantly looking for ways to buck the status quo (in hindsight, even if it meant lying). Given what I now know about him, I wouldn’t be the least bit surprised to find he cherry-picked papers to support his findings regarding CVP and volume status.

It’s entirely possible those meta-analyses on CVP are on the level. But as someone who is a couple weeks away from finishing CV fellowship and has had the ability to correlate filling pressures with end diastolic volumes and cardiac index on a daily basis, I get valuable actionable data from the CVP on the daily.

He suggested throwing CVP in the garbage. I’m not saying CVP = volume status/responsiveness, but I think it definitely still has a role if you know how to interpret it in the context of everything else going on with the patient.

 

[chessknt]

Hopefully he loses his lawsuit against the hospital system where he implemented his quack protocol. It is probably too much to hope he gets to die in jail but if he dies destitute and forgotten that will suffice. He caused so much pain in the ICU with his fake bull**** that these low information antivax families clung to.

 

[coffeebythelake]

Hopefully he loses his lawsuit against the hospital system where he implemented his quack protocol. It is probably too much to hope he gets to die in jail but if he dies destitute and forgotten that will suffice. He caused so much pain in the ICU with his fake bull**** that these low information antivax families clung to.

I think the first step is revoking his medical license for fraud

 

[Agast]

Interesting, I just came across Marik's name because he's part of a group of doctors suing the FDA for restricting the usage of ivermectin.

 

[Katheudontas parateroumen]

Forgive that I haven't read the entire article. But from the abstract it appears this is primarily testing Vitamin C in sepsis, not necessarily Marik cocktail which is VitC, Thiamine and HC which in his papers are supposed to work synergistically. There are other trials which have almost debunked this CITRIS and VITAMINS trial.

 

[chessknt]

Forgive that I haven't read the entire article. But from the abstract it appears this is primarily testing Vitamin C in sepsis, not necessarily Marik cocktail which is VitC, Thiamine and HC which in his papers are supposed to work synergistically. There are other trials which have almost debunked this CITRIS and VITAMINS trial.

His papers are falsified nonsense and he is a quack. No more resources should be wasted on disproving his lies. He can't even practice medicine anymore.

 

[pgg]

His papers are falsified nonsense and he is a quack. No more resources should be wasted on disproving his lies. He can't even practice medicine anymore.

Is there a good summary someplace of the accusations and proof that he falsified data?

I haven't followed it closely, and my prowess in the realm of statistics is suspect, but this analysis seems to argue fairly well that the evidence for fraud is not especially strong:

The curious perfect p-value: a case study in defamation and ignorance

UPDATE 6 June 2022: Sheldrick's defamatory article has now been removed from his blog. My understanding is that this is as a result of legal action against him. But note that the Times is still citing Sheldrick as if he is credible source of Covid information.1. The accusationKyle Sheldrick is...

www.normanfenton.com

I met Dr. Marik a couple times a few years back. He visited and gave a couple lectures on fluid management and the prelim data on Vit C / hydrocortisone / etc cocktail. Don't really have a dog in this fight, other than my general baseline belief that most published research is wrong for one reason or another (but usually for reasons of publication bias or other flaws, not outright fraud).

 

[chessknt]

Is there a good summary someplace of the accusations and proof that he falsified data?

I haven't followed it closely, and my prowess in the realm of statistics is suspect, but this analysis seems to argue fairly well that the evidence for fraud is not especially strong:

The curious perfect p-value: a case study in defamation and ignorance

UPDATE 6 June 2022: Sheldrick's defamatory article has now been removed from his blog. My understanding is that this is as a result of legal action against him. But note that the Times is still citing Sheldrick as if he is credible source of Covid information.1. The accusationKyle Sheldrick is...

www.normanfenton.com

I met Dr. Marik a couple times a few years back. He visited and gave a couple lectures on fluid management and the prelim data on Vit C / hydrocortisone / etc cocktail. Don't really have a dog in this fight, other than my general baseline belief that most published research is wrong for one reason or another (but usually for reasons of publication bias or other flaws, not outright fraud).

https://journals.sagepub.com/doi/full/10.1177/08850666211049062

He was terminated from the medical staff at the end of 2021. I know surgeons who have been caught operating intoxicated who were not terminated from medical staff. You have to be especially egregious to warrant that level of effort.

 

[vector2]

https://journals.sagepub.com/doi/full/10.1177/08850666211049062

He was terminated from the medical staff at the end of 2021. I know surgeons who have been caught operating intoxicated who were not terminated from medical staff. You have to be especially egregious to warrant that level of effort.

He was terminated shortly after he sued Sentara for banning him from using ivermectin. Hard to say if they would've fired him if not for the lawsuit.

 

[chessknt]

He was terminated shortly after he sued Sentara for banning him from using ivermectin. Hard to say if they would've fired him if not for the lawsuit.

He also falsified data from their hospital and was doing unauthorized experiments on patients. I can only assume he was reviled by his coworkers and support staff alike for his pompous statements about how is was malpractice to not be doing ivermecting and plasmapheresis or whatever the flavor of the month was at the time. A lot more to it than just a lawsuit.

 

[vector2]

He also falsified data from their hospital and was doing unauthorized experiments on patients. I can only assume he was reviled by his coworkers and support staff alike for his pompous statements about how is was malpractice to not be doing ivermecting and plasmapheresis or whatever the flavor of the month was at the time. A lot more to it than just a lawsuit.

Yes, I'm aware of all the other crazy sht he was doing. But as you said, there are intoxicated MDs who don't even get fired.

The full answer is that it was probably a combination of things that ultimately led to his termination, but the main thing that will guarantee that your employer immediately fires you is....suing your employer.

 

[Ronin786]

Is there a good summary someplace of the accusations and proof that he falsified data?

I haven't followed it closely, and my prowess in the realm of statistics is suspect, but this analysis seems to argue fairly well that the evidence for fraud is not especially strong:

The curious perfect p-value: a case study in defamation and ignorance

UPDATE 6 June 2022: Sheldrick's defamatory article has now been removed from his blog. My understanding is that this is as a result of legal action against him. But note that the Times is still citing Sheldrick as if he is credible source of Covid information.1. The accusationKyle Sheldrick is...

www.normanfenton.com

I met Dr. Marik a couple times a few years back. He visited and gave a couple lectures on fluid management and the prelim data on Vit C / hydrocortisone / etc cocktail. Don't really have a dog in this fight, other than my general baseline belief that most published research is wrong for one reason or another (but usually for reasons of publication bias or other flaws, not outright fraud).

Marik filed a lawsuit against the hospital on November 9 over its ban on certain therapies. That same day, a paper Marik had published on his MATH+ Hospital Treatment Protocol for COVID-19 was retracted after Sentara raised concerns about it with the Journal of Intensive Care Medicine.

The retraction notice cited a communication it received from Sentara Norfolk General Hospital that questioned "the accuracy of COVID-19 hospital mortality data reported in the article pertaining to Sentara."

According to an excerpt of Sentara's communication published in the retraction notice, the hospital "conducted a careful review of our data for patients with COVID-19 from March 22, 2020 to July 20, 2020, which shows that among the 191 patients referenced in Table 2 that the mortality rate was 10.5%, rather than 6.1%. In addition, of those 191 patients, only 73 patients (38.2%) received at least 1 of the 4 MATH+ therapies, and their mortality rate was 24.7%. Only 25 of 191 patients (13.1%) received all 4 MATH+ therapies, and their mortality rate was 28%."

His hospital sent a letter saying his data was inaccurate.

Controversial Doc Resigns From Medical School

Paul Marik, MD, has been embroiled in legal battle with Virginia hospital

www.medpagetoday.com